摘要/Abstract

摘要： 目的 · 探讨腹膜透析（腹透）患者脂肪含量对左心室肥厚（left ventricular hypertrophy，LVH）的影响。方法 · 选取 2016 年 11 月至 2017 年 6 月在上海交通大学医学院附属仁济医院接受规律腹透治疗的患者作为研究对象。采集患者的人口学资料，检测相关生化指标，并应用多频生物电阻抗分析技术测定脂肪含量，采用彩色多普勒超声检测心脏结构，评估不同脂肪含量腹透患者的 LVH 患病率。应用 Logistic 回归分析 LVH 的影响因素。结果 · 共有 163 例患者入选本研究，其中男性 98 例（60.1%），平均年龄（55.85±13.20）岁，中位透析龄 46.0（20.0，73.0）个月，合并糖尿病 34 例（20.9%），合并心血管疾病 19 例（11.7%），合并高血压 122 例（74.8%）。本组患者中 LVH 共 51 例（31.3%），其中高脂肪组织质量指数（fat tissue index，FTI）组（n=82）患者 LVH 有 31 例（37.8%），低 FTI 组（n=81）患者 LVH 有 20 例（24.7%）。Logistic 回归结果显示，FTI（OR=1.133，95% CI 1.003 ～ 1.280，P=0.044）、容量负荷（OR=1.651，95% CI 1.257 ～ 2.169，P=0.000）和血红蛋白（OR=0.972，95% CI 0.948 ～ 0.997，P=0.028）是 LVH 患病的独立相关因素。结论 · LVH在腹透患者中的患病率高，尤其是脂肪含量高的患者。脂肪含量高、容量负荷高和低血红蛋白是腹透患者 LVH 的危险因素。

关键词: 腹膜透析, 左心室肥厚, 脂肪含量, 生物电阻抗分析
Abstract:
Objective · To explore the association of fat content with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. Methods · Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from November 2016 to June 2017 were recruited.Demographic data of patients were collected and biochemical indicators were measured. Fat content was measured by bioelectrical impedance analysis,and LVH was accessed using echocardiography. The prevalence of LVH in PD patients was compared between groups with different fat contents. Logistic regression was used to analyze the associated risk factors of LVH. Results · A total of 163 PD patients with a mean age of 55.85±13.20 years and a median PD duration of 46.0 (20.0, 73.0) months were enrolled. Of them, 98 patients (60.1%) were male, 34 patients (20.9%) had diabetes mellitus, 19 patients (11.7%) combined with cardiovascular disease and 122 patients (74.8%) were hypertensive. There were 51 patients (31.3%) with LVH, including 31 patients (37.8%) in high fat tissue index (FTI) group (n=82) and 20 patients (24.7%) in low FTI group (n=81). Logistic regression analysis indicated that FTI (OR=1.133, 95% CI 1.003-1.280, P=0.044), overhydration (OR=1.651, 95% CI 1.257-2.169, P=0.000) and hemoglobin (OR=0.972, 95% CI 0.948-0.997, P=0.028) were independently associated with LVH in PD patients. Conclusion · LVH is common in PD patients, especially in high fat content patients. Higher fat content, higher overhydration and lower levels of hemoglobin are risk factors for LVH in PD patients.

Key words: peritoneal dialysis, left ventricular hypertrophy, fat content, bioelectrical impedance analysis


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