摘要
目的分析老年慢性肾衰竭非透析患者心血管并发症的发病情况及特点,并探讨其危险因素。方法选取2011年1月~2015年12月间在本院住院治疗的老年慢性肾衰竭非透析患者112例。应用MDRD公式对肾小球滤过率(eGFR)进行估算分为四组,分别为1eGFR≥45ml/min(27例);2eGFR=30~44 ml/min(26例);3eGFR=15~29 ml/min(36例);4eGFR≤14 ml/min(23例)。收集患者的临床资料、生化指标并进行超声心电图检查,探讨各组间患者心脏结构和功能的变化,并分析其影响因素。结果四组患者平均年龄、血红蛋白、尿酸、尿总蛋白与肌酐比值、钙离子通道阻滞剂使用率、ACEI抑制剂使用率、收缩压和舒张压水平之间差异均有统计学意义(P<0.05)。伴随着eGFR水平降低,患者左心室质量指数逐渐升高,差异有统计学意义(P<0.05);左心室肥厚可分为向心和离心肥厚,各组间向心肥厚和离心肥厚发生率差异均有统计学意义(P<0.05)。Logistic回归分析显示,心血管疾病史、尿总蛋白与肌酐比值、eGFR分组为左心室肥厚的危险因素。左心室舒张和收缩功能减退情况、心包积液和瓣膜反流发生率四组间差异均无统计学意义(P>0.05)。结论老年慢性肾衰竭非透析患者左心室质量指数随着eGFR的降低而升高,主要表现为左心室肥厚,早期以向心性肥厚多见。eGFR分组、心血管疾病史、尿总蛋白与肌酐比值可能为左室肥厚的主要危险因素。
Objective Analyze the incidence and characteristics of cardiovascular complications in chronic renal failure elderly patients,and explore the risk factors of cardiovascular complications. Methods 112 elderly patients with chronic renal failure were hospitalized in our hospital from January 2011 to December 2015 were selected. The application of MDRD formula on the glomerular filtration rate（ e GFR） estimates are divided into four groups,respectively,e GFR = 45 ml / min（ 27cases）; the e GFR = 30 ～ 44 ml / min（ 26 cases）; e GFR = 15 ～ 29 ml / min（ 36 cases）; the e GFR is less than or equal to 14 ml / min（ 23 cases）. Clinical data and biochemical parameters were collected to examine the changes of cardiac structure and function among the patients in each group,and the influencing factors were analyzed. Results Four groups of patients with the average age,hemoglobin,uric acid,urinary protein and creatinine,calcium channel blocker,ACEI inhibitor usage rate,systolic blood pressure and diastolic blood pressure levels between the differences were statistically significant（ P〈0. 05）. With the decrease of e GFR level,left ventricular mass index were gradually increased,the difference was statistically significant（ P〈0. 05）; left ventricular hypertrophy can be divided into concentric and eccentric hypertrophy groups,concentric hypertrophy and hypertrophy of centrifugal rate differences were statistically significant（ P〈0. 05）. Logistic regression analysis showed that the risk factors of cardiovascular disease history,urinary total protein and creatinine ratio,e GFR group were left ventricular hypertrophy. There were no significant difference in the incidence of left ventricular diastolic and systolic dysfunction,pericardial effusion and valve regurgitation（ P〉0. 05）. Conclusion Elderly patients with chronic renal failure in non dialysis patients with left ventricular mass index increased with the decrease of e GFR,mainly for left ventricular hypertrophy,concentric hypertrophy
作者
崔建丰
韩艳玲
王青
刘倩玲
王婉
宋孝鹏
Cui Jianfeng Han Yarding Wang Qing Liu Qianling Wang Wan Song Xiaopeng(Staff hospital of Lnoyang northern Enterprise Group Co. , Ltd. , Luoyang , Henan 471000)
出处
《辽宁医学杂志》
2017年第1期6-8,共3页
Medical Journal of Liaoning
关键词
老年人
慢性肾衰竭
心血管并发症
Elderly
Chronic renal failure
Cardiovascular complications
