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目的探讨慢性肾脏病(CKD)患者血硫酸吲哚酚浓度(IS)变化及与心血管疾病(CVD)相关指标的关系,为CKD患者合并CVD的防治提供临床参考。方法 1112例CKD患者按K/DOQI指南分为CKD 3期、CKD 4期、CKD 5期组,正常对照组40例。2收集临床资料,高效液相色谱-荧光法检测IS浓度。3心脏超声检查左心室舒张末内径(LVDd),室间隔厚度(IVST),左心室后壁厚度(LVPTW),射血分数(EF),二尖瓣舒张晚期血流速度(A)与二尖瓣舒张早期血流速度(E)的比值(A/E)。4硫酸吲哚酚(IS)作因变量,CVD相关指标作自变量进行相关分析。结果 1所有患者的生化指标和IS明显高于对照组。2对照组血IS为(0.08±0.06)μg/ml,CKD3/4/5期分别是(0.13±0.12)μg/ml、(0.48±0.53)μg/ml、(2.74±2.49)μg/ml,差异有统计学意义(P<0.05)。3CKD患者的心脏结构及功能明显异常(P<0.05),表现为室间隔、心室壁增厚和心室内径增大,A/E>1,EF下降。4血IS与CVD相关指标(收缩压、舒张压、TC、TG、LDL-C、P、i PTH、IVST、LVPWT)呈明显正相关。结论CKD患者的IS随肾功能的下降而引起体内积聚;CKD患者合并CVD有心肌肥厚、心室收缩和舒张功能不全等表现;IS在CKD的心血管疾病发生发展中有相关作用。
Objective To investigate the relationship between the concentration of indoxyl sulfate in patients with chronic kidney disease (CKD) and cardiovascular disease (CVD) and to provide a reference for the prevention and treatment of CKD in patients with CKD. Methods 1112 CKD patients were divided into CKD stage 3, CKD stage 4, CKD stage 5, and normal control group according to K / DOQI guidelines. 2 Collecting clinical data, high performance liquid chromatography - fluorescence detection of IS concentration. Left ventricular end-diastolic diameter (LVDd), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPTW), ejection fraction (EF), mitral diastolic velocity (A) Early diastolic blood flow velocity (E) ratio (A / E). 4 Indoxyl sulfate (IS) as a dependent variable, CVD-related indicators as independent variables for correlation analysis. Results 1 All patients had significantly higher biochemical markers and IS than the control group. 2 in the control group were (0.08 ± 0.06) μg / ml and (0.13 ± 0.12) μg / ml, (0.48 ± 0.53) μg / ml and (2.74 ± 2.49) μg / The difference was statistically significant (P <0.05). The cardiac structure and function of patients with 3CKD were significantly abnormal (P <0.05), showing ventricular septal, ventricular wall thickening and ventricular diameter increased, A / E> 1, EF decreased. There was a significant positive correlation between plasma IS and CVD (systolic blood pressure, diastolic blood pressure, TC, TG, LDL-C, P, i PTH, IVST, LVPWT) Conclusion The IS of CKD patients with the decline of renal function caused by the accumulation in the body; CKD patients with myocardial hypertrophy associated with CVD, ventricular systolic and diastolic dysfunction and other performance; IS in CKD-related cardiovascular disease development.