| 慢性肾脏病患者左心室舒张期功能障碍的影响因素分析 |
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| 引用本文： | 于红燕a,杨海平b,耿文彦a,张瑞凤a,李瑞英a,葛世杰a. 慢性肾脏病患者左心室舒张期功能障碍的影响因素分析[J]. 临床荟萃, 2018, 33(11): 974. DOI: 10.3969/j.issn.1004-583X.2018.11.013 |
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| 作者姓名： | 于红燕a 杨海平b 耿文彦a 张瑞凤a 李瑞英a 葛世杰a |
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| 作者单位： | 呼和浩特市第一医院 a.肾内科；b.急诊科，内蒙古呼和浩特 010030 |
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| 基金项目： | 呼和浩特市应用技术研究与开发项目（2016150103000081） |
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| 摘 要： | 目的 评价慢性肾脏疾病（chronic kidney disease, CKD）患者发生左心室舒张功能障碍的风险因素。方法 选取CKD 3～5期患者120例，左心室射血分数（LVEF）>50%。根据二尖瓣环舒张早期峰值速度（EmLV）将患者分为两组：左心室舒张功能障碍（EmLV<8 cm/s）DD(+)组59例和左心室舒张功能正常（EmLV≥8 cm/s）DD(-)组61例。采用标准超声心动仪和多普勒超声心动仪测定所有患者与左心室功能相关的参数。实验室检测血清肌酐、估计肾小球滤过率（eGFR）、尿酸、血钙（Ca）、血磷（P）、甲状旁腺素（PTH）、血红蛋白（Hb）、血小板计数（PLT）和N末端B型钠尿肽前体（NT proB NP）。结果 与DD(-)组比较，DD(+)组血Ca水平降低（P<0.01）。血Ca≤1.98 mmol/L时，诊断左心室舒张功能障碍的灵敏度为92.8%，而特异度为39.2%。血Ca≤1.98 mmol/L是左心室舒张期功能障碍发生的独立危险因素。结论 低钙血症是CKD患者左心室舒张功能障碍的独立危险指标。
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| 关 键 词： | 肾疾病 低钙血症 心室功能 左 |
Influencing factors of left ventricular diastolic dysfunction in patients with chronic kidney disease |
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| Yu Hongyana,Yang Haipingb,Geng Wenyana,Zhang Ruifenga,Li Ruiyinga,Ge Shijiea. Influencing factors of left ventricular diastolic dysfunction in patients with chronic kidney disease[J]. Clinical Focus, 2018, 33(11): 974. DOI: 10.3969/j.issn.1004-583X.2018.11.013 |
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| Authors: | Yu Hongyana Yang Haipingb Geng Wenyana Zhang Ruifenga Li Ruiyinga Ge Shijiea |
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| Affiliation: | a.Department of Nephrology; b.Department of Emergency, Hohhot No.1 Hospital, Hohhot 010030, China |
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| Abstract: | Objective To investigate the risks factors of left ventricular(LV) diastolic dysfunction (DD) in patients with chronic kidney disease (CKD).Methods A total of 120 patients with CKD stage 3 5 and LV ejection fraction (EF)>50% were enrolled in this study.According to the results of peak early diastolic velocity (EmLV), patients were divided into LV diastolic dysfunction (DD+) group (EmLV<8 cm/s) (n=59) and normal LV diastolic dysfunction (DD-) group (EmLV≥8 cm/s) (n=61). Standard echocardiography and tissue Doppler echocardiography were performed to evaluate the parameters related to LV diastolic function. The following laboratory parameters were detected: serum creatinine concentration, estimated glomerular filtration rate, urea, Ca, P, parathormone, platelet count, hemoglobin and N terminal pro B type natriuretic peptide (NT proBNP). Results Compared with DD(-) patients, the level of serum Ca was significantly decreased in DD(+) patients（P<0.01）. ROC curve derived Ca≤ 1.98 mmol/L was characterized by a sensitivity of 92.8% and specificity of 39.2% for diagnosing LV diastolic dysfunction. Moreover, multivariate logistic regression showed that serum Ca≤1.98 mmol/L was the only variable predicting LV diastolic dysfunction.Conclusion Hypocalcemia is the independent predictive factor for LV diastolic dysfunction in patients with CKD. |
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| Keywords: | kidney diseases；hypocalcemia ventricular function left |
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