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目的:分析超声评价慢性肾功能不全患者心血管结构及功能的临床应用价值。方法:回顾性分析2014年1月至2016年12月广东省肇庆市第一人民医院88例慢性肾功能不全患者的临床资料,所有患者均采取彩超检查,测定左室舒张末内径(LVIDD)、左室射血分数(LVEF),并检测血浆B型尿钠肽原(BNP)水平,根据纽约心功能协会心功能分级(NYHA)进行分组,分析不同心功能NYHA分级患者的LVIDD、LVEF、BNP变化情况及LVEF与BNP、心脏彩超测量指标与NYHA分级的关系。结果:不同NYHA分级的慢性肾功能不全患者LVIDD、LVEF、血浆BNP水平比较,差异具有统计学意义(P<0.05);线性回归分析可知,LVEF与BNP具有一定的相关性,且不受性别、年龄、基础病史等因素的影响;Peaarson法分析进一步显示,LVEF与BNP呈负相关,(P<0.05);LVEF与NYHA分级呈负相关(P<0.05),NYHA分级随着LVEF降低而上升,其他心脏彩超测量指标,如左室收缩末容量、左室舒张末容量等均与NYHA分级呈正相关(P<0.05)。结论:超声可监测慢性肾功能不全患者心血管结构及功能改变情况,为临床评估心功能和预后提供有效的参数依据,且无创伤性,操作简便。
Objective: To evaluate the clinical value of ultrasound in evaluating cardiovascular structure and function in patients with chronic renal failure. Methods: The clinical data of 88 patients with chronic renal insufficiency from the First People’s Hospital of Zhaoqing City, Guangdong Province from January 2014 to December 2016 were retrospectively analyzed. All the patients underwent color Doppler ultrasound examination to determine the left ventricular end-diastolic diameter (LVIDD) Left ventricular ejection fraction (LVEF) and plasma BNP level were measured. According to the New York Heart Association functional classification (NYHA), LVIDD, LVEF, BNP Changes and the relationship between LVEF and BNP, cardiac ultrasonography and NYHA classification. Results: The LVIDD, LVEF and plasma BNP levels in patients with NYHA classification were significantly different (P <0.05). The linear regression analysis showed that LVEF and BNP had a certain correlation and were not affected by gender, Age, and basic medical history. Peaarson analysis further showed that LVEF was negatively correlated with BNP (P <0.05), LVEF was negatively correlated with NYHA classification (P <0.05), NYHA classification increased with the decrease of LVEF, Other cardiac ultrasonographic parameters, such as left ventricular end-systolic volume, left ventricular end-diastolic volume were positively correlated with NYHA classification (P <0.05). Conclusion: Ultrasound can monitor the changes of cardiovascular structure and function in patients with chronic renal insufficiency, and provide an effective parameter basis for clinical assessment of cardiac function and prognosis. It is noninvasive and easy to operate.