81例慢性肾脏病左心室结构及功能情况变化的临床分析

目的：研究中晚期慢性肾脏疾病心脏结构、功能变化特征。方法：选择81例慢性肾脏病3-5期患者及30例正常对照，检查心脏超声，测量左心室舒张末内径（LVDd），左心室收缩末期内径（LVDs），室间隔舒张末厚度（IVS），左心室后壁舒张末厚度（PWTH），左心室射血分数（EF），舒张早期和舒张晚期二尖瓣口最大血流速度之比（E/A），用公式计算左心室心肌质量指数（LVMI）、相对室壁厚度（RWT）。结果：81例CKD患者与正常对照组及CKD3-5期组间进行比较，得出以下结果：①81例患者超声心动图结果显示，38．27％存在LVDd增大（49．33±6．78）mm，71．61％存在IVS增厚（12．57±2．58）mm，49．38％存在PWTH增厚（11．91±2．33）mm，30．51％存在EF下降（0．58±0．29）％，41．76％存在E／A下降（0．74±2．99），有93．90％出现左心室肥大（LVH）（LV—MI 187．06±73．85g／m^2），其中向心性肥厚占62．20％，离心性肥厚占23．17％：8．54％已出现向心性重构；只有6．10％结构完全正常。②41．76％左心室舒张功能障碍。结论：慢性肾脏病患者心血管疾病的发生率很高，主要表现为左心室肥大，且以向心性肥厚为主。

THE STRUCTURAL AND FUNCTIONAL ABNORMALITIES OF LEFT VENTRICLE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Objective：To observe the structural and functional changes of heart in patients with intermediate or advanced stage chronic kidney disease（CKD） . Methods：81 patients with CKD were analyzed . Ultrasonic cardiogram was tested to measure LVDd,LVDs,IVS,PWTH,EF and E/A . LVMI was calculated by equation . Resuits： ①The echocardiographic results of 81 patients indicated that there were 93.90% of LVH （LVMI 187.06± 73.85g/m^2）, in which , concentric hypertrophy were 62.20% , eccentric hypertrophy were 23.17% ; 38.27% with enlarged LVDd（49.33±6.78）mm, 71.61%with increased IVS（12.57±2.58）mm, 49.38%with increased PWTH（11.91± 2.33）mm, 30.51%with decreased EF（0.58±0.29）%, 41.76% with decreased E/A（0.74±2.99）,and centrality reconstitution was 8.54% . ②41.76% CKD patients had left ventricle diastolic function disorder . Conclusion：There was high percentage of cardiovascular disease in CKD patients. Most cardiovascular disease was LVH, mainly concentric hypertrophy.