【摘要】 目的探讨血清钙(Ca2+)、磷(P)、钙-磷乘积(Ca2+×P)、血红蛋白(Hb)和血压(BP)对慢性肾脏疾病(CKD)患者左心室功能及质量的影响。方法根据K/DOQI指南分级标准,将102例CKD患者分为中期组(n=42)和晚期组(n=60),比较两组Ca2+、P、Ca2+×P、Hb、BP、左心室射血分数(LVEF)和左心室质量指数(LVMI)的差别,并对LVEF和LVMI与Ca2+、P、Ca2+×P、Hb、收缩压(SBP)和舒张压(DBP)的相关性进行分析。结果晚期CKD组SBP、P、Ca2+×P、LVMI明显高于中期组(P<0.05~0.0001),而Ca2+、Hb和LVEF明显低于中期组(P<0.0001),单变量分析LVEF与P、Ca2+×P、SBP呈明显负相关(P<0.01),LVMI与SBP、DBP、P、Ca2+×P呈明显正相关(P<0.05~0.01),与Hb呈明显负相关(P<0.01),多变量分析LVEF仍保留与P(P=0.03)、SBP(P=0.049)呈显著负相关,LVMI仍保留与Ca2+×P(P=0.038)、SBP(P=0.05)呈显著正相关,与Hb(P=0.02)呈显著负相关。结论除SBP外,血P升高是影响CKD患者LV功能的重要危险因素,血P升高和Hb减少是影响CKD患者LVH的重要危险因素。更多还原

【Abstract】 Objective To invest the effect of serum phosphate(P),calcium(Ca),calcium-phosphate product(Ca2+×P,bemoglobin(Hb),and blood pressure(BP)on left ventricular structure,function in chronic kidney disease(CKD).Methods 102 patients with CKD divided into medium-stage group(n=42)and end-stage group(n=60)based on classify standard of recent K/DOQI clinical guidelines,differences of Ca2+、P、Ca2+×P、Hb、BP、LVEF and LVMI between groups have been compared,and correlation of LVEF、LVMI with Ca2+、P、Ca2+×P、Hb、BP have been analysis.Results Systolic(SBP)、P、Ca2+×P、LVMI of end-stage group was significantly higher than medium-stage group(P<0.05～0.0001),and Ca2+Hb、LVEF was sgnitican tlylower than medium-stage group(P<0.0001) in a univariate regressive analysis,LVEF was closely negative elated to P、Ca2+×P、SBP regressive analysis,LVEF was closely negative related to P、Ca2+×P、SBP(P<0.01),LVMI was closely positive related to SBP、DBP、P、Ca2+×P(P<0.05,P<0.01),and was closely negative related to Hb(P<0.01),in a multivariate regressive analysis,LVEF was closely negative related to P(P=0.03),SBP(P=0.049),LVMI was closely positive related to Ca2+×P(P=0.038)、SBP(P=0.05),and wa closely negative related to Hb(P=0.02).Conclusion Except for SBP,high serum P was important risk factor for imparied LV function of CKD,and high serum P,low Hb was important risk factor for imparied LVH of CKD.更多还原