粥样硬化性肾动脉狭窄程度<70%的患者肾功能损害与心功能的关系
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贵阳市科技基金资助项目〔(2007)筑科技合同字第7-1号〕


The Influence of Renal Dysfunction on Diastolic Function and Systolic Function in Atherosclerotic Renal Artery Stenosis Patients
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    摘要:

    目的探讨粥样硬化性肾动脉狭窄(ARAS)程度<70%的患者肾功能损害与心脏收缩、舒张功能的相关性。方法收集确诊且肾动脉狭窄<70%的37例ARAS患者,按内生肌酐清除率(CCr)分为60 mL/min≤CCr<90 mL/min组(18例)和30 mL/min≤CCr<60 mL/min组(19例)。应用超声心动图测量患者心房及心室内径、室间隔厚度、左心室射血分数(LVEF)、舒张早/晚期心室充盈速度最大值比值(E/A)等各项参数。结果与60mL/min≤CCr<90 mL/min组比较,30 mL/min≤CCr<60 mL/min组患者的心室收缩、舒张功能明显减弱(P<0.05);CCr与LVEF(r=0.324,P<0.05)﹑E/A(r=0.587,P<0.01)呈正相关。结论ARAS<70%的患者已有不同程度肾功能损害,其损害程度与狭窄程度无关,与心功能衰竭程度加重相伴随,预示预后不良。

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    Aim To investigate association of heart function with renal function in patients with atherosclerotic renal artery stenosis(ARAS)<70%. Methods Renal artery stenosis were <70% in 37 patiens with ARAS,they were divided into two groups based on endogenous creatinine clearance rate(CCr).CCr was detected by serum creatinine(SCr).Group A: 60 mL/min≤CCr<90 mL/min.GroupB: 30 mL/min≤CCr<60 mL/min.Left atrial diameter(LAD),left ventricular end-diastolic diameter(LVDd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(IVPW),early and late wave of mitral valve flow(E/A),ejection fraction(EF),the inside diameter shortened fraction(FS) were determined using echocardiography. Results Compared with group A,indexes of cardia diastolic function and systolic function such as left ventricular ejection fraction(LVEF),EF,FS in group B were significantly decreased(P<0.05).Pearson correlation analysis indicated that CCr was positively correlated to the LVEF(r=0.324,P<0.05)and E/A(r =0.587,P<0.01). Conclusion Severity of diastolic dysfunction and systolic dysfunction correlate with the severity of renal dysfunction in ARAS patients.Renal dysfunction has a high clinical prediction in severity cardiovascular events in ARAS patients.

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黄朝晖,赵洪雯,吴雄飞,毛华,蒋清安,杨永曜.粥样硬化性肾动脉狭窄程度<70%的患者肾功能损害与心功能的关系[J].中国动脉硬化杂志,2011,19(12):1008~1010.

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  • 收稿日期:2011-08-25
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