早期慢性肾脏疾病患者左室肥厚及其相关因素分析

目的探讨早期慢性肾脏疾病(CKD)患者左室肥厚(LVH)及其相关因素.方法:回顾性分析110例肾功能稳定的早期CKD患者LVH发生率及其与血压、血红蛋白(Hb)、肾功能、甲状旁腺激素(PTH)等临床资料的关系.结果(1)LVH在CKD早期即已存在,随着内生肌酐清除率(Ccr)的下降,左室质量指数(LVMI)逐渐增加,LVH发生率逐渐增高;(2)与非LVH组相比,LVH组收缩压(SBp)(P＜0.01)、舒张压(DBp)(P＜0.05)、血肌酐(Scr)(P＜0.01)和血尿酸(UA)(P＜0.01)水平显著增高,Hb和Ccr水平显著低下(P均＜0.01);(3)单因素相关分析显示LVMI与SBp、DBp、Scr、UA成显著正相关(r值分别为0.465,0.385,0.599,0.482;P均＜0.01),而与Hb、Ccr成显著负相关(r值分别为-0.561,-0.465;P均＜0.01).多因素逐步回归分析显示DBp、Hb、UA进入回归方程,所得回归方程为y=1.887x1-0.158x1 0.123x3 61.355(y=LVMI;x1=DBP;x2=UA;x3=Hb;66.169为常数).结论LVH在CKD早期即已存在,且随着肾功能减退更加明显,其发生与高血压、贫血、高尿酸血症等因素相关.

Left Ventricular Hypertrophy and Its Related Factors in Early Chronic Kidney Disease

Objective: To investigate left ventricular hypertrophy (LVH) and its related factors in early chronic kidney disease. Methods: The clinical data of 110 early chronic kidney disease (CKD) patients with steady renal function were retrospectively analyzed. We analyzed the incidence of LVH in CKD patients and the relation between left ventricular mass index (LVMI) and clinical data such as blood pressure (BP), hemoglobin (Hb), serum creatinine (Scr), creatinine clearance rate (Ccr), uric acid (UA), parathyroid hormone (PTH) and so on. Results: (1) Even early CKD patients suffered from LVH. With the declining of Ccr, both the value of LVMI and the incidence of LVH increased significantly. (2) Compared with the non-LVH group, the LVH one had higher levels of SBp (P<0. 01), DBp (P< 0. 05), Scr (P<0. 01) and UA (P<0. 01), but lower levels of Hb and Ccr (P<0. 01). (3) The value of LVMI had a significant positive correlation with SBp, DBp, Scr and UA(r=0. 465, 0. 385, 0. 599, 0. 482, respectively, P<0. 01), but a negative correlation with Hb and Ccr (r=-0. 561 ,-0.465, respectively,P<0. 01). Conclusion: Even early CKD patients may suffer from LVH, and it is more severe with the decline of renal function. The pathogenesis of LVH in early CKD patients may attribute to high blood pressure, anemia, elevated uric acid and so on.