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目的:分析慢性肾脏病3期(CKD3)2型糖尿病肾病患者超声心动图变化,探讨其变化特点与年龄、血脂、血压、血红蛋白、尿蛋白等因素之间的关系。方法:121例确诊为CKD3期的患者,按照原发病不同分为糖尿病肾病组和非糖尿病肾病组,对其年龄、血脂、血压、血红蛋白、尿蛋白等相关临床资料及超声心动图检查结果进行对比分析和多因素分析。结果:CKD3期糖尿病肾病患者贫血发生率84%,与非糖尿病肾病患者相比,贫血发生率高、程度重,尿蛋白排泄率高。心脏结构改变以左室舒末内径增大,左室肥厚为主。功能改变以舒张功能减退为特点。血红蛋白(Hb)与左室舒张末期内径(LVEDd)、左室心肌质量指数(LVMI)相关;尿蛋白(Pr)与二尖瓣血流心房收缩期最大流速(AV)及其比值E/A相关。结论:CKD3期糖尿病肾病患者心脏病变受多因素影响,贫血、尿蛋白等因素作用不容忽视。提示早期积极纠正贫血,控制血压,减少尿蛋白排泄可能是糖尿病肾病患者减少或延缓心血管并发症的重要措施。
OBJECTIVE: To analyze the changes of echocardiography in type 2 diabetic nephropathy patients with chronic kidney disease stage 3 (CKD3) and to explore the relationship between the changes and age, blood lipid, blood pressure, hemoglobin and urinary protein. Methods: One hundred and twelve patients diagnosed as CKD3 were divided into diabetic nephropathy group and non-diabetic nephropathy group according to their primary disease. The clinical data and echocardiographic findings of age, blood lipid, blood pressure, hemoglobin, Comparative analysis and multivariate analysis. Results: The incidence of anemia in patients with CKD stage 3 diabetic nephropathy was 84%. Compared with non-diabetic nephropathy patients, the incidence of anemia was high, and the level of urinary protein excretion was high. Changes in cardiac structure, left ventricular end-diastolic diameter increased, mainly left ventricular hypertrophy. Functional changes to diastolic dysfunction characterized. Hemoglobin (Hb) was correlated with left ventricular end-diastolic dimension (LVEDd) and left ventricular mass index (LVMI); urinary protein (Pr) was correlated with the maximum systolic velocity of mitral flow . Conclusion: Cardiac pathology in patients with CKD stage 3 diabetic nephropathy is affected by many factors, such as anemia and urinary protein, which can not be ignored. Prompt early positive correction of anemia, blood pressure control, reduce urinary protein excretion may be diabetic nephropathy in patients with an important measure to reduce or delay cardiovascular complications.