左房室瓣环钙化与肾功能的关系研究

目的探讨左房室瓣环钙化(MAC)与慢性肾功能不全之间的相关性。方法选择河北医科大学附属石油医院肾内科住院期间进行超声心动图检查发现有MAC的患者82例(MAC组),根据瓣环受累的部位不同分为仅后叶瓣环受累的局限组和前后叶瓣环均受累的广泛组。选取无MAC患者73例为对照组。测定患者的血清肌酐水平并计算肾小球滤过率(eGFR)。结果 MAC组的肌酐水平高于对照组(95μmol/L∶86μmol/L,P<0.001),而eGFR低于对照组(55.8 ml/min∶65.7 ml/min,P=0.005)。57%的MAC患者存在慢性肾脏疾病,即GFR<60 ml/min,发生率是对照组(40%)的1.4倍(P<0.05)。MAC广泛组与局限组eGFR分别为58.6 ml/min和43.2 ml/min,差异有统计学意义(P<0.05)。eGFR和MAC程度呈负相关(rs=-0.28,P<0.001)。结论 MAC与肾脏功能之间存在显著相关性。MAC的存在提示临床医生应警惕慢性肾脏疾病的可能。

Relationship between Mitral Annular Calcification and Renal Function

Objective To explore the relationship between mitral annular calcification(MAC) and renal dysfunction.Methods Eighty-two patients with echocardiographically confirmed MAC were enrolled in this study.Based on the scope of MAC,they were further divided into limitation group,in which the calcification was largely limited to the posterior annulus,and extensive group,in which the calcification was extended to the anterior annulus.Seventy-three patients without MAC were enrolled as the control group.Serum creatine level was determined and glomerular filtration rate(GFR) was calculated.Results Serum creatine level in MAC group was significantly higher than that in control group(95 μmol/L vs 86 μmol/L,P<0.001),while GFR was significantly lower(55.8 ml/min vs 65.7 ml/min,P=0.005).It was found 57% of the MAC patients had chronic kidney disease(GFR<60 ml/min),which was 1.4 times as much as that in the control group(40%)(P<0.05).GFR in MAC extensive group and MAC limitation group were 58.6 ml/min and 43.2 ml/min,respectively(P<0.05).The GFR level and MAC level were negatively correlated(rs=-0.28,P<0.001).Conclusion MAC is correlated with chronic kidney disease.The existence of MAC may suggest the possible chronic kidney disease.