尿毒症性心肌病相关危险因素的临床调查研究

Clinical investigation of risk factors associated with uremic cardiomyopathy

关键词:  尿毒症性心肌病  危险因素  慢性肾功能衰竭

Key words:  uremic cardiomyopathy  risk factor  chronic renal failure

摘要:

[目的] 通过回顾性病例对照研究分析尿毒症性心肌病的相关危险因素。[方法] 随机选取本院肾病科诊断为慢性肾功能衰竭患者135例，其中尿毒症性心肌病88例、无尿毒症性心肌病组47例，收集所有研究对象的性别、年龄等基本情况，肾功能、总蛋白、血钙、血磷、血脂及心脏彩超等临床资料，通过统计方法筛选出尿毒症性心肌病的相关危险因素。[结果] 尿毒症性心肌病组总蛋白、白蛋白、血钙浓度均显著低于对照组（P<0.05），而血肌酐、尿素氮、血磷水平虽明显高于对照组，但统计学差异无统计学意义（P>0.05），尿毒症性心肌病的危险因素为血肌酐升高，总蛋白水平的升高是其保护性因素（P<0.05）。[结论] 毒素蓄积、低蛋白血症、钙磷代谢紊乱是尿毒症性心肌病的相关危险因素，对决定尿毒症患者的防治策略具有重要意义。

Abstract:

[Objective] To analyze the risk factors of uremic cardiomyopathy by retrospective case-control study.[Methods] The 135 patients with chronic renal failure were enrolled in this study. There were 88 cases of uremic cardiomyopathy and 47 cases with on uremic cardiomyopathy group. To collect all the subjects, such as gender, age and other basic conditions, renal function, total protein, serum calcium, blood phosphorus, blood lipids and heart color ultrasound and other clinical data, through a one-sided Student's t test, chi-square test and second-class logistic regression analysis and other statistical methods to identify the risk factors of uremic cardiomyopathy.[Results] The total protein, albumin and serum calcium concentration in uremic cardiomyopathy group were significantly lower than those in control group (P<0.05), serum creatinine, urea nitrogen and serum phosphorus levels were significantly higher than the control group, but the statistical difference was not significant(P>0.05). The logistic analysis showed that the risk factor for uremic cardiomyopathy was serum creatinine, and the total protein was the protective factor (P<0.05).[Conclusion] Toxins accumulation, hypoproteinemia and metabolic disorders of calcium and phosphorus are the relevant risk factors of uremic cardiomyopathy, which is of great significance to determine the prevention and treatment strategy of uremic patients.