糖尿病肾病肾功能衰竭患者血清胆红素与左室舒张功能的关系

发布时间：2018-03-06 16:55

本文选题：糖尿病肾病　切入点：肾功能衰竭　出处：《广东医学》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨糖尿病肾病(DKD)肾功能衰竭(肾衰竭)患者血清总胆红素(TB)、间接胆红素(IB)、直接胆红素(DB)与左心室舒张功能之间的关系。方法收集2型糖尿病肾病肾衰竭患者90例,并选择同期在门诊检查的健康者(正常对照组)20例,将患者按肾小球滤过率(e GFR)分为CKD 3期、CKD 4期及CKD 5期组,检测各组血清TB、IB、DB的水平,测量各组舒张末期室间隔厚度(IVST)、左心室后壁厚度(LVPW)、左室舒张末内径(LVID)、左室射血分数(EF)、二尖瓣瓣尖舒张早期最大血流速度(E)、晚期最大血流速度(A),并根据左室舒张功能不全(LVDD)的诊断标准(E/A1且EF50%),将DKD肾衰竭患者分为LVDD组及非LVDD组。结果DKD肾衰竭患者血清TB、IB、DB均较正常对照组显著减少(P0.05);随着e GFR的下降,3组患者血清TB、IB逐渐减少(P0.05),但DB下降无统计学意义(P0.05);与非LVDD组比较,LVDD组TB、IB、E/A下降及IVST、LVPW升高有统计学意义(P0.05),DB、LVID下降及EF升高差异无统计学意义(P0.05)。Pearson相关分析提示,对于DKD患者,TB、DB、IB分别与IVST、LVPW呈显著负相关(均P0.01),与LVID、EF、E/A呈正相关,但无统计学意义(均P0.05);LVDD组患者TB、IB分别与IVST、LVPW呈明显负相关(均P0.01),DB虽与IVST、LVPW呈负相关,但无统计学意义(P0.05),TB、DB、IB分别与LVID、EF、E/A呈正相关,但无统计学意义(均P0.05)。结论血清胆红素水平可间接反映DKD肾衰竭患者左室舒张功能。及早检测血清胆红素水平,做到早诊断、早预防、早治疗,可减少心血管并发症的发生、发展。
[Abstract]:Objective to investigate the relationship between serum total bilirubin (TBN), indirect bilirubin (IBB), direct bilirubin (DBB) and left ventricular diastolic function in patients with diabetic nephropathy (DKD). Methods 90 cases of renal failure with type 2 diabetic nephropathy were collected. Twenty healthy subjects (normal control group, n = 20) were divided into two groups according to glomerular filtration rate (GFR): CKD stage 3, CKD 4 and CKD 5. The end diastolic septal thickness (IVSTT), left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVIDD), left ventricular ejection fraction (EFN), mitral peak diastolic velocity (MVD) and late peak diastolic velocity (MVD) were measured in each group, and according to left ventricular diastolic work, left ventricular diastolic work was evaluated. Patients with DKD renal failure were divided into two groups: LVDD group and non-#en2# group. Results the serum TBI IBB DB in DKD patients was significantly lower than that in the normal control group (P 0.05), and with the decrease of e GFR, the serum TBIB in the three groups decreased gradually. However, there was no significant difference in the decrease of DB between the two groups (P 0.05), and there was no significant difference between the two groups in the decrease of LVDD IBE / A and the increase of LVPW in IVST-LVPW. There was no significant difference between the two groups (P 0.05). Pearson correlation analysis suggested that there was no significant difference between the two groups, and there was no significant difference between the two groups in P0.05. Pearson correlation analysis showed that there was no significant difference between the two groups. There was a significant negative correlation between DKD and LVPW (all P 0.01), but there was no significant difference between them (all P0.05 and LVPW LVPW) (all P0.01DB was negatively correlated with IVSTT LVPW, all P0.01DB was negatively correlated with IVSTT LVPW, all P0.01DB was negatively correlated with IVSTT LVPW, all P0.01DB was negatively correlated with IVSTT LVPW. However, there was no significant difference between serum bilirubin and LVID-EFE / A, but there was no significant difference (P 0.05). Conclusion Serum bilirubin level can indirectly reflect left ventricular diastolic function in patients with DKD renal failure, early detection of serum bilirubin level, early diagnosis and early prevention. Early treatment can reduce the occurrence and development of cardiovascular complications.
【作者单位】：南昌市第三医院肾内科;
【分类号】：R587.2;R692.5

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