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慢性肾脏病患者心功能状况的临床回顾性研究(肾脏组稿,重投)
Clinical retrospective investigation of cardiac function in patients with chronic kidney disease
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DOI:
作者:
李蓉
LiRong
作者单位:
上海交通大学医学院附属新华医院崇明分院肾脏内科
Department of Nephrology, Shanghai Xinhua Hospital of Chongming branch
关键词:
慢性肾脏病;心功能;透析;回顾性研究
Chronic kidney disease (CKD); Cardiac function; Dialysis; Retrospective study.
摘要:
目的 了解崇明地区不同分期、原发性或继发性、有无透析及不同透析方式的慢性肾脏病(CKD)患者的心功能状况,探讨CKD患者合并心血管疾病(CVD)可能的危险因素,为临床早期干预CKD患者合并CVD,降低CKD患者的致残及致死率,提高CKD患者的生存率提供理论依据。方法 回顾性分析我院100例CKD患者,分别根据CKD患者的不同分期、有无透析、不同透析方式、原发性或继发性各分为两组,比较其心功能指标。结果 CKD4-5期患者血磷、BNP、血β2微球蛋白、甲状旁腺激素、左室舒张内径均高于CKD1-3期患者,血红蛋白浓度则低于CKD1-3期患者;透析患者血磷、BNP、血β2微球蛋白、甲状旁腺激素均高于未透析患者,左室射血分数则低于未透析患者;腹膜透析患者血β2微球蛋白高于血液透析患者,血钾、左室舒张内径则低于血液透析患者;继发性CKD患者血红蛋白浓度低于原发性CKD患者。结论 CKD4-5期患者心功能较CKD1-3期患者降低;透析患者心功能较未透析患者降低;血液透析患者与腹膜透析患者心功能状况无明显差异;继发性CKD患者与原发性CKD患者心功能无明显差异。
Objective: to investigate the cardiac function of patients of Chongming district with chronic kidney disease (CKD) at different stages and under different dialysis modes, and explore the possible risk factors of CKD patients with cardiovascular disease (CVD), so as to provide theoretical basis for early clinical interference, decrease of the disability rate and mortality rate of CKD patients and improvement of the survival rate. Methods: one hundred CKD patients of the Hospital were retrospectively analyzed. The patients were divided into two groups according to different CKD stages, whether there was dialysis, dialysis methods, primary or secondary CKD, so as to compare their cardiac function. Results: the serum phosphorus, BNP, bloodβ2-microglobulin,parathyroid hormone,and left ventricular end diastolic diameter of the patients with CKD at the fourth and fifth stage were all higher than those of the patients with CKD at the first three stages, and their hemoglobin concentration was lower than that of the patients with CKD at the fourth and fifth stage;the serum phosphorus, BNP, bloodβ2-microglobulin,parathyroid hormone,and left ventricular end diastolic diameter of the hemodialysis patients were all higher than those of the patients without hemodialysis,and their left ventricular ejection fraction were lower than that of the patients without dialysis; the bloodβ2-microglobulin of the patients with peritoneal dialysis was higher than that of the hemodialysis patients, and their serum potassium and left ventricular diastolic diameter were lower than those of the hemodialysis patients.The hemoglobin concentration of patients with secondary CKD was lower than that of primary CKD patients. Conclusion: Cardiac function of patients with CKD at the fourth and the fifth stage was lower than that of patients with CKD at the first three stages. Cardiac function of hemodialysis patients and peritoneal dialysis patients was not significantly different. The cardiac function of patients with primary CKD and patients with secondary CKD was not significantly different.
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