摘要
目的探讨慢性肾脏脏病5期非透析(ND-CKD5)患者发生左心室肥厚(LVH)的危险因素,为预防ND-CKD5患者LVH发生提供依据。方法纳入2022年2月-2023年3月于桂林医科大学第一附属医院肾内科就诊住院的255例ND-CKD5患者的临床资料,按照LVH发生情况分为LVH组与NLVH组,比较两组临床资料,采用多因素Logistic回归分析ND-CKD5期患者发生LVH的危险因素,并采用ROC曲线分析ND-CKD5患者发生LVH的预测指标。结果纳入的255例ND-CKD5患者发生LVH 125例,发生率为49.02%。两组高血压病史、收缩压、Hb、Ca、P、BUN、胱抑素C、β_(2)-MG、CK、D-二聚体、iPTH比较,差异有统计学意义(P<0.05),而两组其余指标比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示,高血压病史、收缩压、Hb、β_(2)-MG为ND-CKD5患者发生LVH的独立危险因素;ROC曲线分析显示,收缩压、Hb、β_(2)-MG预测ND-CKD5患者发生LVH的ROC曲线下面积分别为0.601、0.622、0.657,而联合预测LVH的ROC曲线下面积为0.725,95%CI为0.663~0.788,敏感度为60.80%,特异度为76.15%。结论LVH在ND-CKD5患者中的发生率高,且收缩压、Hb、β_(2)-MG均是ND-CKD5患者LVH发生的独立危险因素,以上危险因素联合检测对预测LVH发生具有较好的临床价值。
Objective To investigate the risk factors of left ventricular hypertrophy(LVH)in non-dialysis patients with stage 5 chronic kidney disease(ND-CKD5),and to provide evidence for the prevention of LVH in patients with ND-CKD5.Methods The clinical data of 255 patients with ND-CKD5 admitted to the Department of Nephrology,the First Affiliated Hospital of Guilin Medical University from February 2022 to March 2023 were included.According to the occurrence of LVH,they were divided into LVH group and NLVH group.The clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the risk factors of LVH in patients with ND-CKD5,and ROC curve was used to analyze the predictors of LVH in patients with ND-CKD5.Results Among the 255 patients with ND-CKD5,125 had LVH,with an incidence of 49.02%.There were significant differences in the history of hypertension,systolic blood pressure,Hb,Ca,P,BUN,cystatin C,β_(2)-MG,CK,D-dimer and iPTH between the two groups(P<0.05),there was no significant difference in the other indexes between the two groups(P>0.05).Multivariate Logistic regression analysis showed that history of hypertension,systolic blood pressure,Hb andβ_(2)-MG were independent risk factors for LVH in patients with ND-CKD5.ROC curve analysis showed that the area under the ROC curve of systolic blood pressure,Hb andβ_(2)-MG in predicting LVH in ND-CKD5 patients was 0.601,0.622 and 0.657,respectively,while the area under the ROC curve of combined prediction of LVH was 0.725,95%CI was 0.663-0.788,sensitivity was 60.80%,and specificity was 76.15%.Conclusion The incidence of LVH is high in patients with ND-CKD5,and systolic blood pressure,Hb andβ_(2)-MG are independent risk factors for LVH in patients with ND-CKD5.The combined detection of the above risk factors has good clinical value in predicting the occurrence of LVH.
作者
秦菊
马云华
谢敏慧
阳文秀
邓洁
欧俊
廖雪玲
QIN Ju;MA Yunhua;XIE Minhui;YANG Wenxiu;DENG Jie;OU Jun;LIAO Xueling(Department of Nephrology,the First Affiliated Hospital of Guilin Medical University,Guilin 541000,Guangxi,China;Department of Ultrasound,the First Affiliated Hospital of Guilin Medical University,Guilin 541000,Guangxi,China)
出处
《医学信息》
2025年第18期37-41,共5页
Journal of Medical Information
基金
广西壮族自治区卫生健康委自筹经费科研课题(编号:Z-C20230867)。
关键词
慢性肾脏病
非透析
左心室肥厚
Chronic kidney disease
Non-dialysis
Left ventricular hypertrophy
