老年维持性血液透析病人左心室舒张功能障碍的危险因素分析  

Analysis of risk factors of left ventricular diastolic dysfunction in elderly patients with maintenance hemodialysis

作　　者：董凤鸣 黄碧坤 曹婧媛 陈慧敏 张裕[1] 张留平[3] 张伟 DONG Fengming;HUANG Bikun;CAO Jingyuan;CHEN Huimin;ZHANG Yu;ZHANG Liuping;ZhANG Wei(Blood Purification Center,Taizhou People’s Hospital Affiliated to Nanjing Medical University,Taizhou 225300,China;Taizhou Vocational and Technical College,Taizhou 225300,China;Blood Purification Center,Zhongda Hospital Southeast University,Nanjing 210009,China;Blood Purification Center,Taizhou Third People’s Hospital,Taizhou 225300,China)

机构地区：[1]南京医科大学附属泰州人民医院血液净化中心,江苏省泰州市225300 [2]泰州职业技术学院,江苏省泰州市225300 [3]东南大学附属中大医院血液净化中心,江苏省南京市210009 [4]泰州第三人民医院血液净化中心,江苏省泰州市225000

出　　处：《实用老年医学》2024年第7期658-661,共4页Practical Geriatrics

基　　金：江苏省卫生健康委员会医学科研项目(M2021048);南京医科大学泰州临床医学院科研项目(TZKY20220209);北京健康促进会中国血液透析血管通路青年医师研究项目。

摘　　要：目的 探讨老年维持性血液透析(maintenance hemodialysis, MHD)病人发生左心室舒张功能障碍(left ventricular diastolic dysfunction, LVDD)的影响因素。方法 选取2022年3—12月于东南大学附属中大医院血液净化中心行透析治疗的老年MHD病人178例,根据是否发生LVDD将病人分为LVDD组和非LVDD组。收集并比较2组一般资料、实验室指标及心脏结构相关参数,采用Logistic回归分析老年MHD病人发生LVDD的危险因素。结果 LVDD组透析龄和舒张末室间隔厚度(IVST)、甲状旁腺激素、脑钠肽水平显著高于非LVDD组(P<0.05)。多因素Logistic回归分析显示,透析龄(OR=1.284,95%CI:1.102~1.497)和IVST(OR=11.434,95%CI:5.942~118.404)为老年MHD病人发生LVDD的危险因素(P<0.01)。结论 临床对透析龄较长、IVST较高的老年MHD病人要警惕LVDD的发生。Objective To explore the risk factors of left ventricular diastolic dysfunction(LVDD)in the elderly patients undergoing maintenance hemodialysis(MHD).Methods A total of 178 elderly MHD patients who underwent dialysis treatment in Blood Purification Center of Zhongda Hospital Southeast University from March to December 2022 were enrolled in this study,and were divided into LVDD group and non-LVDD group.General information,biochemical indicators and echocardiographic indexes were collected and compared between the two groups.Multivariate Logistic regression analysis was used to screen the independent risk factors for LVDD in the elderly MHD patients.Results The dialysis age and the levels of interventricular septal thickness(IVST),parathyroid hormone(PTH),and brain natriuretic peptide(BNP)in LVDD group were significantly higher than those in non-LVDD group(P<0.05).Multivariate Logistic regression analysis showed that dialysis age(OR=1.284,95%CI:1.102-1.497)and IVST(OR=83.876,95%CI:5.942-118.404)were the risk factors for LVDD in the elderly MHD patients(P<0.01).Conclusions It is important to pay attention to LVDD in the elderly MHD patients with high levels of dialysis age and IVST.

关 键 词：老年人 维持性血液透析 左心室舒张功能障碍 危险因素 

分 类 号：R459.5[医药卫生—治疗学]