腹膜透析患者残余肾功能与左心室质量的相关性分析

目的探讨腹膜透析患者残余肾功能与左心室质量及左心室质量指数的关系。方法选取我院接受持续不卧床腹膜透析治疗半年以上的慢性肾衰竭患者103例，将其根据残余肾肌酐清除率（Ccr）水平分为3组，A组31例：Cer为0～2ml·min-1·（1．73m2）-1；B组42例：Cer为2～4ml·min-1·（1．73m2）；C组30例：Ccr〉4ml·min-1·（1．73m2）-1。所有入选患者均检测残余肾Ccr、平均动脉压（MBP）、血钙、血磷、血清全段甲状旁腺素（iPTH）、左心室质量及左心室质量指数，并进行组间统计学分析。结果3组患者MBP和血钙水平差异无统计学意义（P〉0．05）；与A组相比，B组和C组患者血磷、钙磷乘积、iPTH、左心室质量及左心室质量指数降低（P〈0．01）；Pearson相关分析显示，Ccr与血磷（r=-0．384，P=0．000）、钙磷乘积（r=-0．344，P=0．000）及iPTH（r=-0．435，P=0．000）存在负相关关系；左心室质量及左心室质量指数与MBP（r=0．300，P=0．002；r=0．240，P=0．015）、血磷（r=0．332，P=0．001；r=0．241，P=0．014）、钙磷乘积（r=0．284，P=0．004；r=0．212，P=0．032）、iPTH（r=0．266，P=0．007；r=0．226，P=0．021）存在正相关关系。结论左心室质量及左心室质量指数增加与残余肾功能的丧失有一定的相关性，积极保护残余肾功能可以减少心血管疾病发生率和病死率。

The analysis of correlation between the residual renal function and left ventricle weight in peritoneal dialysis patients

Objective To investigate the relationship between the residual renal function （RRF） and left ventricle weight（LVW）and left ventricular mass index （LVMI） in peritoneal dialysis patients. Methods 103 patients treated with peritoneal dialysis for at least 6 months were investigated. Patients were divided into three groups according to the creatinine clearance rate （Ccr）. The group A （n = 31 ） ： Ccr 0-2 ml.min 1 .（1.73m2 ） - 1 ,group B （n = 42） ：Cer 2-4 ml.min-1 . （1.73m2 ） 1 ,group C（n = 30） ： Ccr2〉4 ml.min -1. （1.73 m2） -1. The residual Ccr,mean arterial pressure, serum parathormone concentration, serum calcium and phosphonium concentration were investigated. The LVM and LVMI were assessed by ultrasonic cardiogram. Results There were no significant differences in the mean arterial pressure and serum calcium concentration between the three groups（P〉0. 05）. Compared with group A,the serum phosphonium, multiplication of calcium and phosphorus, iPTH, LVW and LVMI were significantly lower in group B and C（P〈0. 01 ）. By Pearson relative analysis, Ccr were significantly negative correlated with serum phosphonium （r = - 0. 384, P = 0. 000）, multiplication of calcium and phosphorus （r = - 0. 344, P = 0. 000） and iPTH （r = - 0. 435, P = 0. 000）. Meanwhile, LVW and LV MI were significantly positive correlated with the mean arterial pressure （r = 0. 300, P = 0. 002; r = 0. 240, P = 0. 015）, serum phosphonium （r = 0. 332, P = 0. 001 ;r = 0. 241, P = 0. 014）, multiplication of calcium and phosphorus （r = 0. 284, P = 0. 004; r = 0. 212, P = 0. 032） and iPTH （r = 0. 266, P = 0. 007; r = 0. 226,P = 0. 021 ）. Conclusions Our data showed that the strong relationship between the losing of residual renal function and the increasing of LVW and LVMI. Portecting the residual renal function positivly can reduce the incidence rate of cardiovascular disease and the mortality rate in peritoneal dialysis patients.