摘要
目的调查青年维持性血液透析（MHD）患者心血管疾病的发病情况和病变特点，并探讨其危险因素。方法采用横断面研究。MHD患者98例，以45岁为界分为青年组（47例）和中老年组（51例）。收集患者临床资料和生化指标。心脏超声检查测量心脏腔径及心功能参数。分析青年组患者心脏结构和功能异常的患病率、病变特点及其影响因素。结果（1）47例青年患者中有30例（63．8％）存在心脏结构异常，主要表现为左心室肥厚、左心房增大和瓣膜反流，患病率分别为61．7％、38．3％和34．0％。（2）青年组患者向心性肥厚的患病率为86．2％，离心性肥厚的患病率为13．8％，与中老年组相比，差异有统计学意义（P〈0．05）。（3）与无心脏病变青年MHD患者相比，伴心脏病变者的超滤量、收缩压、血磷和甲状旁腺激素明显增高，而Kt／V、血红蛋白和血清白蛋白明显降低，差异有统计学意义（P〈0．05）。Logistic回归分析结果显示，超滤量、收缩压、血红蛋白和血甲状旁腺激素是青年MHD患者并发心脏病变的独立危险因素。结论青年MHD患者心血管疾病的患病率较高，主要表现为左心室肥厚、左房增大和瓣膜反流。超滤量、收缩压、血红蛋白和血甲状旁腺激素水平可能是影响青年MHD患者并发心脏病变的独立危险因素。
Objective To investigate the changes of cardial structure and function, and explore the risk factors of cardiovascular disease in young maintenance hemodialysis （MHD） patients. Methods A total of 98 cases on MHD were enrolled in this study. Among them, 47 patients were young. The cardial structure and function were assessed by echocardiography. The following data were collected： age, gender, ultrafiltration volum, Kt/V, blood pressure, hemoglobin, albumin, lipid, calcium phosphorus product and parathyroid hormone, etc. T test, χ^2 test and binary logistic regression analysis were performed for statistics. Results The echocardiography images showed that the incidence of cardial structure and function abnormalities in young MHD patients was 63.8%. The main manifestations were left ventricular hypertrophy, left atrium augmentation and valvular regurgitation, and their prevalence was 61.7%, 38.3% and 34.0% respectively. The prevalence of concentric hypertrophy and eccentric hypertrophy in young MHD patients was 86.2% and 13.8% respectively, which was significantly different as compared with middle-aged and old-aged MHD patients. There were no significant differences of left ventricular hypertrophy, valvular regurgitation, left atrium enlargement, left ventricular diastolic dysfunction, left ventricular systolic dysfunction, pericardial effusion, pulmonary artery hypertension and valvular calcification between young and middle- and old-aged MHD patients. The levels of uhrafihration volume, systolic blood pressure, serum phosphorus and parathyroid hormone were significantly higher in young MHD patients with cardial abnormality than in those without cardial abnormality. The levels of Kt/V, hemoglobin and serum albumin were significantly lower in young MHD patients with cardial abnormality than in those without cardial abnormality. Logistic regressive analysis revealed that uhrafihration volume, systolic blood pressure, hemoglobin and parathyroid hormone were important risk factors of cardial abnormality in young
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2007年第8期505-509,共5页
Chinese Journal of Nephrology
关键词
肾透析
心血管疾病
超声心动描记术
青年
Renal dialysis
Cardiovascular disease
Echocardiography
Youth
