慢性肾功能不全患者甲状旁腺素水平与心电图V1导联P波终末电势的相关性及对左心室舒张功能障碍的预测价值  

Correlation between parathyroid hormone level and P wave terminal potential in lead V1 in patients with chronic renal insufficiency and the predictive value for left ventricular diastolic dysfunction

作　　者：高文强 吴淑红[1] 赵晓霞 李璐 郝志敏[2] GAO Wen-qiang;WU Shu-hong;ZHAO Xiao-xia;LI Lu;HAO Zhi-min(Internal Medicine Department,Shanghai Huangpu District Cancer Prevention Hospital,Shanghai 200126,China;Department of General Medicine,South Hospital of the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200126,China)

机构地区：[1]上海市黄浦区肿瘤防治院内科,上海市200126 [2]上海交通大学附属第六人民医院南院全科医学科

出　　处：《中国心血管病研究》2024年第2期155-160,共6页Chinese Journal of Cardiovascular Research

基　　金：2021年度黄浦区卫生健康系统科研项目(HLM202126)。

摘　　要：目的探析慢性肾功能不全患者甲状旁腺素(PTH)水平与心电图V1导联P波终末电势(PTFv1)的相关性,并分析二者对左心室舒张功能障碍的预测价值。方法纳入2021年10月至2023年3月自黄浦区肿瘤防治院150例慢性肾功能不全患者为研究对象,所有患者入院时均接受PTH水平检测,并完善心电图和超声心动图检查,观察慢性肾功能不全患者PTH水平与心电图检查指标、超声心动图检查指标的相关性。统计所有患者左心室舒张功能障碍发生状况,并将其分为功能障碍组与功能正常组,对比两组基线资料及PTH水平与PTFv1,采用多因素logistic回归分析慢性肾功能不全患者左心室舒张功能障碍的影响因素,并绘制受试者工作特征(ROC)曲线分析PTH水平与PTFv1对左心室舒张功能障碍的预测价值。结果150例慢性肾功能不全患者PTH水平为(159.64±76.32)pg/ml,PTFv1为[-0.3(-0.2,-0.3)]mm·s,左心房内径(LAD)为(37.42±4.68)mm,左心室内径(LVDD)为(48.25±4.39)mm;Pearson相关性分析显示,慢性肾功能不全患者PTH水平与PTFv1呈负相关(r=-0.443,P<0.05),与LAD、LVDD呈正相关(r=0.345、0.523,P<0.05);150例慢性肾功能不全患者中发生左心室舒张功能障碍71例,占47.33%;功能障碍组LAD、LVDD、PTH水平高于功能正常组,PTFv1低于功能正常组(P<0.05);Logistic回归分析显示,LAD、LVDD、PTH是慢行肾功能不全患者发生左心室舒张功能障碍的危险因素(OR>1,P<0.05),PTFv1是保护因素(OR<1,P<0.05);ROC曲线显示,PTH、PTFv1对慢性肾功能不全患者发生左心室舒张功能障碍具有一定预测价值(AUC=0.863、0.753),联合预测价值更高(AUC=0.869)。结论慢性肾功能不全患者PTH水平与PTFv1呈负相关,PTH水平越高,左心房及左心室越大,临床可通过检测PTH水平预测患者左心室舒张功能障碍。Objective To explore the correlation between parathyroid hormone(PTH)level and P wave terminal potential in lead V1(PTFv1)of the electrocardiogram in patients with chronic renal insufficiency and the predictive value for left ventricular diastolic dysfunction.Methods 150 patients with chronic renal insufficiency in Huangpu District Cancer Prevention And Control Hospital from October 2021 to March 2023 were selected as the research objects.All the patients were tested for PTH level when they were admitted to the hospital,electrocardiogram and color Doppler ultrasound.The correlation between PTH level and ECG and color Doppler ultrasound was observed.The incidence of left ventricular diastolic dysfunction in all the patients was counted and divided into the dysfunction group and normal function group.The baseline data,PTH level and PTFv1 of the two groups were compared.The influencing factors of left ventricular diastolic dysfunction were analyzed by multivariate logistic regression,and the predictive value of PTH level and PTFv1 on left ventricular diastolic dysfunction was analyzed by drawing the ROC curve of subjects.Results In 150 patients,the PTH level was(159.64±76.32)pg/ml,PTFv1 was[-0.3(-0.2,-0.3)]mm·s,Left atrial diameter(LAD)was(37.42±4.68)mm and Left ventricular diameter(LVDD)was(48.25±4.39)mm.Pearson correlation analysis showed that PTH level in the patients was negatively correlated with PTFv1(r=-0.443,P<0.05),and positively correlated with LAD and LVDD(r=0.345,0.523,P<0.05).Among 150 patients,71 cases developed left ventricular diastolic dysfunction,accounting for 47.33%.The levels of LAD,LVDD and PTH in the dysfunction group were higher than those in the normal group,and PTFv1 was lower than that in normal group(P<0.05).Logistic regression analysis showed that LAD,LVDD and PTH were the risk factors of left ventricular diastolic dysfunction in the patients(OR>1,P<0.05),and PTFv1 was the protective factor(OR<1,P<0.05).The ROC curve analysis showed that PTH and PTFv1 had certain predictive value for

关 键 词：慢性肾功能不全 甲状旁腺素 心电图V1导联P波终末电势 左心室舒张功能障碍 

分 类 号：R541[医药卫生—心血管疾病]