目的:应用超声心动图技术评价原发性肾病综合征(PNS)患者心脏结构和左心室功能参数的改变，分析上述改变与实验室检查指标的相关性。方法:回顾性分析2018年9月至2020年2月于四川省人民医院就诊的194例PNS患者(PNS组)和184例健康成年人(对照组)的临床资料。收集PNS组和对照组心脏结构参数舒张末期升主动脉内径(AAOD)、收缩末期左心房内径(LAD)、舒张末期左心室内径(LVDD)、舒张末期室间隔厚度(IVST)、舒张末期左心室后壁厚度(LVPWT)、舒张末期主肺动脉内径(MPAD)、右心室舒张末期内径(RVDD)和功能参数左心室射血分数(LVEF)、二尖瓣口舒张早期血流速度峰值(E)、舒张晚期血流速度峰值(A)、二尖瓣环间隔壁舒张早期运动速度峰值(Em)、舒张晚期运动速度峰值(Am)，并计算左心室质量(LVM)、E/A、Em/Am和E/Em；另收集PNS组的实验室检查结果，获取疾病活动指标红细胞沉降率(ESR)、C反应蛋白(CRP)及肾功能指标血肌酐(Cre)、估算肾小球滤过率(eGFR)，与年龄、收缩压(SBP)、舒张压(DBP)一起纳入临床指标以备后续分析。比较PNS组与对照组超声心动图检查结果差异，并与临床指标及分类变量高脂血症、贫血、甲状旁腺功能亢进进行相关性分析。结果:(1)超声心动图分析：①构型参数：PNS组AAOD、IVST、RVDD、MPAD和LVM较对照组增大，差异有统计学意义(均n P<0.05)；②功能参数：PNS组与对照组相比，E、E/A、Em和Em/Am减小，差异有统计学意义(均n P<0.05)。(2)相关性分析：①AAOD、RVDD、IVST、MPAD和LVM与eGFR呈负相关(n r＝-0.16～-0.294，均n P<0.05)，AAOD、IVST、LVM与年龄、SBP、DBP、Cre呈正相关(n r＝0.219～0.576，均n P<0.01)，RVDD与SBP、Cre呈正相关(n r＝0.208、0.281，均n P<0.01)，MPAD与年龄、SBP呈正相关(n r＝0.147、0.237，均n P＝0.001)，LVM、IVST与CRP呈正相关(n r＝0.205、0.264，均n P<0.05)；②E/Em与年龄、SBP、DBP呈正相关(n r＝0.241～0.291，均n P<0.01)，与eGFR呈负相关(n r＝-0.213，n P＝0.003)，E、E/A、Em、Em/Am与年龄呈负相关(n r＝-0.464～-0.694，均n P<0.001)，E/A、Em、Em/Am与eGFR呈正相关(n r＝0.200～0.269，均n P<0.01)，Em、Em/Am与SBP呈负相关(n r＝-0.193、-0.229，均n P<0.01)；③RVDD与血脂水平升高呈正相关(n r＝0.186，n P＝0.017)。n 结论:PNS可引起患者心脏重塑和功能障碍，与患者年龄、肾性高血压、Cre浓度、eGFR、CRP水平和高脂血症密切相关。超声心动图有助于PNS心脏受累的早期发现，可为临床及时干预PNS心血管病变提供量化评价信息。“,”Objective:To evaluate the changes of cardiac structure and left ventricular function parameters of patients with primary nephrotic syndrome(PNS) by echocardiography, and to analyze the correlation between the pathophysiological cardiac changes and laboratory findings.Methods:One hundred and ninety-four cases with primary nephrotic syndrome patients (PNS group) and 184 cases of healthy adults(control group) in Sichuan Provincial People′s Hospital from September 2018 to February 2020 were analyzed retrospectively. Cardiac configuration parameters such as ascending aortic end-diastolic diameter (AAOD), end-systole left atrial diameter (LAD), left ventricular end-diastolic diameter (LVDD), end-diastolic interventricular septal thickness (IVST), and end-diastolic left ventricular posterior wall thickness(LVPWT), end-diastolic main pulmonary artery diameter (MPAD), right ventricular end-diastolic diameter (RVDD) and functional parameters including left ventricular ejection fraction (LVEF), peak value of early diastolic velocity (E), peak value of late diastolic velocity (A), peak value of early diastolic tissue Doppler velocity (Em) and peak value of late diastolic tissue Doppler velocity (Am) were collected, and LVM, E/A, Em/Am, E/Em were calculated. In addition, the laboratory results of PNS group were collected to obtain ESR, CRP and Cre, eGFR, which were included in the clinical indexes together with age, SBP and DBP for further analysis. The differences of echocardiography results between PNS group and control group were analyzed by statistical analysis. The correlations between the echocardiographic results and clinical indicators and classification variables of hyperlipidemia, anemia, hyperparathyroidism were analyzed.Results:(1)Echocardiographic analyses: ①configuration parameters: compared with the control group, AAOD, IVST, RVDD, MPAD in PNS group were all increased (all n P<0.05); ②functional parameters: compared with the control group, E, E/A, Em, Em/Am decreased and E/Em, A increased in PNS group(alln P<0.05). (2)Correlation analyses: ① AAOD, RVDD, IVST, MPA and LVM were negatively correlated with eGFR (n r=-0.16--0.294, all n P<0.05); AAOD, IVST and LVM were positively correlated with age, SBP, DBP and Cre(n r=0.219-0.576, all n P<0.01); RVDD was positively correlated with SBP and Cre (n r=0.208-0.281, all n P<0.01); MPA was positively correlated with age and SBP (n r=0.147, 0.237, all n P=0.001); LVM and IVST were positively correlated with CRP(n r=0.205, 0.264, all n P<0.05). ②E/Em was positively correlated with age, SBP, DBP(n r=0.241-0.291, all n P<0.01), and negatively correlated with eGFR(n r=-0.213, n P=0.003); E, E/A, Em, Em/Am were negatively correlated with age (n r=-0.464--0.694, all n P<0.001); E/A, Em, Em/Am were positively correlated with EGFR (n r=0.2-0.269, all n P<0.01); Em, Em/Am were negatively correlated with SBP (n r=-0.193, -0.229, all n P<0.01). ③RVDD was positively correlated with blood lipid level (n r=0.186, n P=0.017).n Conclusions:PNS can cause cardiac remodeling and dysfunction, which are closely related to age, renal hypertension, serum creatinine concentration, glomerular filtration rate, CRP level and hyperlipidemia. Echocardiography is helpful for the early detection of PNS cardiac involvement, and provides quantitative evaluation information for clinical timely intervention of PNS cardiovascular disease.