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目的:探讨青年狼疮性肾炎(lupus nephritis,LN)患者左心室肥厚的发生率及其相关危险因素。方法:回顾性分析2000年1月至2014年7月我院310例小于40岁确诊LN的患者,按照左室质量指数(left ventricular mass index,LVMI)分为左室肥厚(LVH)组及非左室肥厚(Non-LVH)组,比较两组患者一般情况、生化指标之间的差异,同时了解LVH的相关危险因素。结果:310例青年LN患者中LVH发生率为40.6%(n=126)。与Non-LVH组患者相比,LVH组患者男性比例少,血压(收缩压、舒张压)、血脂(总胆固醇、甘油三酯)、血肌酐、血尿酸、血磷、高敏C反应蛋白、补体C4、24h尿蛋白高,同时血钙、eGFR、血红蛋白低(P<0.05)。多因素Logistic分析示收缩压、高敏C反应蛋白与LVH发生率呈正相关,血红蛋白、e GFR与LVH发生率负相关(P<0.05)。结论:青年LN患者LVH发生率较高,其中高血压、贫血、炎症状态及肾功能减退是其LVH的独立危险因素。
Objective: To investigate the incidence of left ventricular hypertrophy in young patients with lupus nephritis (LN) and its related risk factors. Methods: A retrospective analysis of 310 patients with LN less than 40 years old in our hospital from January 2000 to July 2014 was divided into left ventricular hypertrophy (LVH) group and non-LVH group according to left ventricular mass index (LVMI) Left ventricular hypertrophy (Non-LVH) group, the two groups of patients in general, biochemical differences between the same time, understand the relevant risk factors of LVH. Results: The incidence of LVH in 310 young LN patients was 40.6% (n = 126). Compared with patients in the non-LVH group, the proportion of male patients in the LVH group was significantly lower than that in the non-LVH group (P <0.05). Blood pressure (systolic blood pressure, diastolic blood pressure), blood lipids (total cholesterol, triglyceride), serum creatinine, C4, 24h urinary protein, while serum calcium, eGFR, hemoglobin low (P <0.05). Multivariate logistic analysis showed that systolic blood pressure and high-sensitivity C-reactive protein were positively correlated with the incidence of LVH. There was a negative correlation between hemoglobin and eGFR and the incidence of LVH (P <0.05). Conclusion: The incidence of LVH in young patients with LN is high. Hypertension, anemia, inflammatory state and renal dysfunction are the independent risk factors of LVH.