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肾功能受损在高血压患者舒张性心力衰竭发生中的作用 预览 被引量:4

The role of impaired renal function in the development of diastolic heart failure in hypertensive patients
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摘要 目的探讨肾功能受损程度对高血压患者舒张性心力衰竭发生的影响。方法回顾性分析165例经超声心动图证实有左心室舒张功能不全的原发性高血压患者的临床资料和超声心动图指标,根据患者有无心力衰竭的临床表现分为舒张性心力衰竭组(46例)和舒张性心功能不全组(119例)。对两组间临床特征、肾功能指标包括血肌酐水平、肌酐清除率、肾小球滤过率以及各项超声心动图参数进行比较。结果舒张性心力衰竭组患者平均年龄明显高于舒张性心功能不全组[(70.35±9.13)岁vs.(62.64±10.09)岁,P<0.001]。与舒张性心功能不全组相比,舒张性心力衰竭组患者血肌酐水平亦明显升高[(111.31±34.11)μmol/Lvs.(98.07±21.76)μmol/L,P=0.019]。两组患者肌酐清除率(CrCl)和肾小球滤过率(eGFR)均处于较低水平,且舒张性心力衰竭组CrCl和eGFR均显著低于舒张性心功能不全组[(56.49±21.37)ml/minvs.(67.46±23.27)ml/min,P=0.007;(60.28±18.00)ml·min-1·(1.73m2)-1vs.(67.29±17.83)ml·min-1·(... Objective To evaluate the effect of impaired renal function on the development of diastolic heart failure in hypertensive patients.Methods 165 patients with essential hypertension and diastolic dysfunction confirmed by echocardiography were retrospectively investigated in the present study.The patients were divided into two groups according to whether they presented with heart failure:diastolic heart failure group (n=46) and diastolic dysfunction group (n=119).Clinical variables,renal function characterized by serum creatinine levels (SCr),creatinine clearance (CrCl) and estimated glomerular filtration rate (eGFR),and echocardiographic parameters were compared between the two groups.Results Patients in diastolic heart failure group were significantly older than those in diastolic dysfunction group[(70.35±9.13)years vs.(62.64±10.09) years,P<0.001].The serum levels of creatinine were statistically higher in diastolic heart failure group compard with those in diastolic dysfunction group[ (111.31±34.11)μmol/L vs.(98.07±21.76)μmol/L,P=0.019].There were significantly lower levels of both CrCl and eGFR in patients with diastolic heart failure than in patients with diastolic dysfunction [(56.49±21.37)ml/min vs.(67.46±23.27)ml/min,P=0.007; (60.28±18.00) ml·min-1·(1.73 m2)-1 vs.(67.29±17.83) ml·min-1·(1.73 m2)-1,P=0.027].With regard to the echocardiographic parameters,left atrial diameter and left atrial area were significantly larger in patients in diastolic heart failure group compared with those in diastolic dysfunction group[(40.17±6.99)mm vs.(37.20±4.50)mm,P=0.010; (23.24±7.77)cm2 vs.(20.18±3.73)cm2,P=0.014],while there were no statistical differences in either E/A or E/Em between the two groups.Conclusions The degree of impaired renal function associated with increased volume load may play an important role in the development of diastolic heart failure in hypertensive patients.
作者 聂颖 王贵松 冯新恒 李昭屏 陈宝霞 朱丹 高炜 NIE Ying,WANG Gui-song,FENG Xin-heng,LI Zhao-ping,CHEN Bao-xia,ZHU Dan,GAO Wei.Department of Cardiology,Peking University Third Hospital,Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,Ministry of Health,Key Laboratory of Molecular Cardiovascular Sciences,Ministry of Education,Beijing 100191,China
出处 《中华临床医师杂志(电子版)》 2011年第19期 5680-5684,共5页 Chinese Journal of Clinicians(Electronic Edition)
关键词 高血压 心力衰竭 舒张性 肾功能不全 舒张性心功能不全 Hypertension Heart failure,diastolic Renal insufficiency Diastolic dysfunction
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参考文献12

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