慢性肾脏病维持性血液透析合并心功能损害特征及危险因素分析  

Characteristics and Risk Factors of Cardiac Function Impairment in Patients with Chronic Kidney Disease Undergoing Maintenance Hemodialysis

作　　者：康兰兰 李亚峰[1] Kang Lanlan;Li Yafeng(Department of Nephrology,The Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第五临床医学院肾内科,太原030000

出　　处：《成都医学院学报》2025年第2期236-240,共5页Journal of Chengdu Medical College

基　　金：国家自然科学基金面上项目(No:82170716)。

摘　　要：目的 探究慢性肾脏病(CKD)维持性血液透析(MHD)合并心功能损害的特征及危险因素。方法 选取2023年7月至2024年7月山西医科大学第五临床医学院收治的211例行MHD治疗的CKD患者为研究对象,比较不同特征MHD患者心功能损害率差异,分析心功能损害的影响因素。结果 211例MHD患者中,65例(30.81%)发生心功能损害;患有贫血、血清β2-微球蛋白(β2M)>3 mg/L、血清可溶性生长刺激表达基因2蛋白(sST2)>35μg/L、N端B型利钠肽前体(NT-proBNP)≥125 ng/L的人群心功能损害率较高(P<0.05);不同年龄、性别、体重指数、透析时间、心血管疾病家族史、糖尿病、吸烟史、饮酒史、收缩压、舒张压、钙磷乘积、白蛋白、甘油三酯、总胆固醇、空腹血糖、糖化血红蛋白人群的心功能损害率比较,差异无统计学意义(P>0.05);多因素分析结果显示,贫血、血清β2M>3 mg/L、血清sST2>35μg/L、NT-proBNP≥125 ng/L为影响MHD患者心功能损害的危险因素(P<0.05)。结论 在进行MHD治疗的CKD患者中,心功能损害率较高,患者是否贫血及血清β2M、sST2、NT-proBNP水平是影响心功能损害的主要因素。Objective To explore the characteristics and risk factors of cardiac function impairment in patients with chronic kidney disease(CKD)undergoing maintenance hemodialysis(MHD).Methods The clinical data of 211 CKD patients treated with MHD in the Fifth Clinical Medical College of Shanxi Medical University from July 2023 to July 2024 were retrospectively analyzed.The incidence of cardiac function impairment among MHD patients with different characteristics was compared.And the influencing factors of cardiac function impairment were analyzed.Results Among the 211 MHD patients included,65 cases(30.81%)experienced cardiac function impairment.Patients with anemia,serumβ2-microglobulin(β2M)>3 mg/L,serum soluble growth-stimulated expressed gene 2 protein(sST2)>35μg/L,and N-terminal pro-B-type natriuretic peptide(NT-proBNP)≥125 ng/L exhibited a higher rate of cardiac function impairment(P<0.05).There was no significant difference in the rate of cardiac function impairment in patients with different age,gender,body mass index,dialysis duration,family history of cardiovascular diseases,diabetes mellitus,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,calcium-phosphorus product,albumin,triglyceride,total cholesterol,fasting blood glucose and glycosylated hemoglobin(P>0.05).Multivariate analysis showed that anemia,serumβ2M>3 mg/L,serum sST2>35μg/L,and NT-proBNP≥125 ng/L were risk factors for cardiac function impairment in MHD patients(P<0.05).Conclusion Among CKD patients undergoing MHD treatment,the probability of cardiac function impairment is high.Anemia and serumβ2M,sST2 and NT-proBNP levels are the main risk factors for the occurrence of cardiac function impairment.

关 键 词：慢性肾脏病 维持性血液透析 心功能 影响因素 

分 类 号：R459.5[医药卫生—治疗学]