俞盛　何飞民

[摘要] 目的 分析影响单中心腹膜透析患者左室肥厚的危险因素。 方法 对我中心2017年1月至2019年6月符合要求的常规腹膜透析患者进行回顾性分析。收集96例患者的年龄、透析年限、收缩压、清蛋白、心脏彩超等资料。通过左心室质量指数（LVHI）评价左室肥厚，用身高2.7标化计算左室质量指数。将男性LVHI>50 g/m2.7，女性>47 g/m2.7作为分界点，观察两组患者在一般资料和实验室检验的区别。 结果 96例腹膜透析患者中LVHI增加者有74例（77.08%），LVHI增加组中患者的透析年限明显较长，体质量指数较大，收缩压水平较高，清蛋白水平较低，且使用肾素-血管紧张素系统（RAS）抑制剂的例数较少。Logistic回归分析显示，LVHI的增加与较长的透析年限、低清蛋白及未使用RAS抑制剂有关。 结论 腹膜透析患者透析时间的延长、清蛋白的降低可以加重LVHI的增加，而RAS抑制剂的使用可以阻止这一过程的发生。

[关键词] 左室肥厚;腹膜透析;肾素-血管紧张素系统;清蛋白

[中图分类号] R459.5          [文献标识码] B          [文章编号] 1673-9701（2021）14-0052-04

Analysis of related factors of left ventricular hypertrophy in single-center peritoneal dialysis patients

YU Sheng   HE Feimin

Department of Nephrology，Sanming First Hospital in Fujian Province， Sanming   365000， China

[Abstract] Objective To analyze the risk factors of left ventricular hypertrophy in single-center peritoneal dialysis patients. Methods The routine peritoneal dialysis patients who met the requirements from January 2017 to June 2019 in our center were retrospectively analyzed. The age， dialysis years， systolic blood pressure， albumin， heart color doppler ultrasound of the 96 patients were collected. The left ventricular hypertrophy was evaluated using left ventricular mass index （LVHI）， and the left ventricular mass index was calculated using height2.7. The differences in general data and laboratory tests between the two groups were compared， taking LVHI>50 g/m2.7 for men and 47 g/m2.7 for women as the demarcation point. Results Among 96 peritoneal dialysis patients， 74 （77.08%） had increased LVHI. Patients in the increased LVHI group had significantly longer dialysis years， larger body mass index， higher systolic blood pressure， and lower albumin levels. Fewer people used the renin-angiotensin system（RAS） inhibitors. Logistic regression analysis showed that the increase in LVHI was related to longer dialysis years， low albumin and no use of RAS inhibitors. Conclusion Prolonged dialysis time and decreased albumin in peritoneal dialysis patients can aggravate the increase of LVHI， and the use of RAS inhibitors can prevent this process from occurring.

[Key words] Left ventricular hypertrophy; Peritoneal dialysis; Renin-angiotensin system; Albumin

慢性肾脏病已成为中国人群的一种常见病，最近的统计数据表明，其发病率为10.8%，占住院患者的4.8%。腹膜透析是终末期CKD的主要治疗方式之一，透析患者心血管疾病患病率高达45.5%，其主要死亡原因就是心血管疾病[1-5]，后者包括高血压、心肌梗死、心衰、恶性心律失常等。左室肥厚（Left ventricular hypertrophy，LVH）是以上疾病的常见表现，临床常用左心室质量指数（Left ventricular mass index，LVMI）衡量左室肥厚情況。国内外指南明确提出可以通过左心室质量指数判断高血压患者的预后[2，6-8]。目前国内外对影响长期腹膜透析患者左室质量指数的因素研究较少，通过对我院随访的腹膜透析患者的一般情况、实验室资料、心脏彩超等进行回顾性分析，从而对造成腹膜透析患者左室肥厚的相关因素进行分析，现报道如下。