高磷血症与血液透析患者左室重量随时间增加的关系  

Association of hyperphosphatemia with longitudinal changes in left ventricular mass of patients with hemodialysis

作　　者：邹慧莹 张爱华 马捷 ZOU Hui-ying;ZHANG Ai-hua;MA Jie(Department of Internal Medicine,Beijing Puren Hospital,Beijing 100062,China;Department of Nephrology,Beijing Friendship Hospital,Beijing 100050,China)

机构地区：[1]北京市普仁医院内科,北京100062 [2]北京市友谊医院肾内科,北京100050

出　　处：《哈尔滨医科大学学报》2024年第3期249-253,共5页Journal of Harbin Medical University

基　　金：北京市自然科学基金面上项目(7222065)。

摘　　要：目的探讨高磷血症与血液透析患者左室重量(left ventricular mass,LVM)进行性恶化的关系。方法选取2019年3月~2021年3月104例来自我院血液净化中心的维持性血液透析患者,根据血磷水平分为正常组(23例)及高磷血症组(81例),随访2年。收集患者基本资料、2年内透析记录及相关实验室检查,同时基线及随访结束时分别行超声心动图检查评价LVM及其变化情况。分析不同血磷水平与LVM变化的关系。结果存在高磷血症的患者LVM的增加值和增加百分比均显著高于血磷正常者(P<0.05)。LVM增加者2年内平均的血钙、血磷和超敏C反应蛋白水平显著高于未增加者(P<0.05)。Logistic回归分析显示只有血磷是LVM随时间增加的独立预测因子(P<0.05)。结论高磷血症是血液透析患者LVM进行性增加的独立危险因素。Objective To investigate the relationship between hyperphosphatemia with longitudinal changes in left ventricular mass(LVM)of patients with hemodialysis(HD).Methods From March 2019 to March 2021,104 maintenance hemodialysis patients from our Blood Purification Center were divided into a normal group(23 cases)and a hyperphosphatemia group(81 cases)based on their blood phosphorus levels,followed up for 2 years.The basic social data,dialysis records,and laboratory parameters were collected.Echocardiography was performed at baseline and at the end of follow-up to evaluate LVM and its changes.The relationship between serum phosphate level and LVM changes during 2 years was assessed.Results LVM increased in patients with hyperphosphatemia were significantly higher than those with normal serum phosphate(P<0.05).The time-average serum calcium,phosphate,and high-sensitivity C-reactive protein levels in patients with increased LVM were significantly higher than those without increased LVM(P<0.05).Logistic regression analysis showed that serum phosphate was an only independent predictor of LVM increase over time(P<0.05).Conclusion Hyperphosphatemia is an independent risk factor for the progressive increase of LVM in HD patients.

关 键 词：血液透析 高磷血症 左室重量 左室肥厚 

分 类 号：R459.5[医药卫生—治疗学]