论文部分内容阅读
目的探讨钙磷代谢与慢性肾功能不全患儿心血管结构与功能关系。方法研究对象为1998—2004年在哈尔滨医科大学附属第一医院住院的44例慢性肾功能不全非透析患儿(非透析组)、另选40例维持性透析患儿(透析组),40例健康志愿者设为对照组。测量指标包括入选对象血液生化指标、超声心动图及颈动脉超声。结果与对照组比较,非透析组及透析组患儿均出现明显的颈动脉增厚、左心室肥厚、舒张功能减退。透析组动脉厚度及心室肥厚指标高于非透析组,且其动脉硬化较其他两组明显。两个肾脏疾病组颈动脉壁增厚与钙磷乘积增加呈正相关,动脉硬化、心室肥厚及舒张功能减退与血清磷及全段甲状旁腺素增加有关。结论慢性肾脏疾病患儿可合并心血管结构与功能异常;血液透析患儿心血管疾病的加重与钙磷代谢异常有关。
Objective To investigate the relationship between calcium and phosphorus metabolism and cardiovascular structure and function in children with chronic renal failure. Methods The subjects were 44 children with chronic renal insufficiency (non-dialysis group) who were hospitalized in the First Affiliated Hospital of Harbin Medical University from 1998 to 2004. Another 40 children (dialysis group) Healthy volunteers as a control group. Measurement indicators include blood biochemical indicators of selected subjects, echocardiography and carotid ultrasound. Results Compared with the control group, carotid artery thickening, left ventricular hypertrophy and diastolic dysfunction were found in both non-dialysis group and dialysis group. Dialysis group arterial thickness and ventricular hypertrophy index higher than non-dialysis group, and atherosclerosis than the other two groups was significantly. The carotid artery wall thickening was positively correlated with the increase of calcium and phosphorus product in two kidney disease groups. The atherosclerosis, ventricular hypertrophy and diastolic dysfunction were related to the increase of serum phosphorus and whole parathyroid hormone. Conclusion Children with chronic kidney disease may have cardiovascular structural and functional abnormalities. The increase of cardiovascular disease in children with hemodialysis may be related to abnormal calcium and phosphorus metabolism.