慢性肾脏病患者左心室结构和功能变化的临床分析

目的探讨慢性肾脏病(CKD)患者心脏收缩、舒张功能及形态结构改变。方法应用多普勒超声法测量93例CKD患者LVDs、LVDd、IVS、PWTH、EF及FS,计算LVMI。结果 CKD 5期患者LVMI为(126.5±46.5)g/m2,显著高于CKD 1～2期(87.2±23.2)g/m2;在CKD 3～5期患者中,左心室舒张功能不全占70.1%;22.5%有心包积液、56.3%伴二尖瓣反流;LVH发生率为39.4%。结论左心室心肌质量指数随肾功能的降低而增加;CKD3～5期患者左心室肥厚、二尖瓣反流及心包积液发生率高;左心室舒张功能受累现象普遍,是心功能不全的早期表现。

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 chronic kidney disease(CKD).Methods A total of 93 patients with CKD were analyzed.Ultrasonic cardiogram was performed to measure LVDs LVDd,IVS,PWTH,EF and FS.LVMI wascalculated by equation.Results LVMI of the patients with CKD at stage 5 was(126.5±46.5)g/m2,much higher than that of the patients at 1 to 2 stage(87.2±23.2g/m2);the echocardiographic results of 93 patients indicated that among CKD stage 3 to 5 patients,LVH occurred in 39.4% of patients,while 70.1% had diastolic function disorder;22.5% had pericardial effusion and 56.3% had mitral regurgitation.Conclusion The mass index of left ventricle increases with the decrease of the renal function.The incidence of LVH,mitral regurgitation and pericardial effusion are high among patients with CKD at 3 to 5 stage.The diastolic function disorder occurs often and early.