摘要
目的 探讨左房僵硬度指数(LASI)评价不同程度慢性肾脏病(CKD)患者左房功能的临床价值。方法 选取我院收治的CKD患者104例,根据估算肾小球滤过率(eGFR)分为CKD1组(eGFR≥30 ml/min)52例和CKD2组(eGFR<30 ml/min)52例,另选同期体检健康成人52例为对照组,比较各组一般资料、实验室指标、常规超声心动图参数及左房应变参数的差异;Spearman相关分析法分析LASI与心肌损伤标志物及肾功能指标的相关性;多重线性回归分析LASI的影响因素;组内相关系数(ICC)分析左房储存期纵向应变(LASr)、LASI在观察者内及观察者间的重复性。结果 对照组、CKD1组、CKD2组肌钙蛋白T(cTnT)、肌红蛋白(Myo)、N末端脑钠肽前体(NT-proBNP)、血肌酐(Scr)、尿素(Urea)、胱抑素C(Cys-C)、LASI均依次增大,eGFR依次减小,各组两两比较差异均有统计学意义(均P<0.05)。相关性分析显示,LASI与cTnT、Myo、NT-proBNP、Urea、Scr、Cys-C均呈正相关(r=0.581、0.487、0.601、0.443、0.517、0.572,均P<0.001),与eGFR呈负相关(r=-0.577,P<0.001)。多重线性回归分析显示,在调整体质量指数、年龄、性别、高血压、糖尿病等影响因素后,NT-proBNP、Urea、Scr、eGFR、Cys-C均与LASI均独立相关(均P<0.05)。重复性检验显示,LASr、LASI在观察者内和观察者间的重复性均良好(观察者内ICC=0.992、0.975,观察者间ICC=0.995、0.985)。结论 LASI可作为评价不同程度CKD左房功能的有效指标,其值随CKD病情进展而增大。
Objective To investigate the clinical value of left atrial stiffness index(LASI)in evaluating left atrial function in patients with different stages of chronic kidney disease(CKD).Methods A total of 104 CKD patients who admitted to our hospital were selected.They were divided into two groups according to estimated glomerular filtration rate(eGFR):CKD1 group(eGFR≥30 ml/min,n=52)and CKD2 group(eGFR<30 ml/min,n=52).Additionally,52 healthy adults underwent physical examinations during the same period were selected as the control group.The differences in general data,laboratory parameters,conventional echocardiographic parameters and left atrial strain parameters were compared among the groups.Spearman correlation analysis was used to analyze the correlation between LASI and cardiac injury markers,as well as renal function parameters.Multiple linear regression analysis was performed to analyze the influencing factors of LASI.Intraclass correlation coefficient(ICC)was used to analyze the repeatability of left atrial longitudinal strain(LASr)and LASI within intra-observer and inter-observer.Results The cardiac troponin T(cTnT),myoglobin(Myo),N-terminal pro-brain natriuretic peptide(NT-proBNP),serum creatinine(Scr),Urea,cystatin C(Cys-C)and LASI in the control group,CKD1 group and CKD2 group increased in turn,while eGFR decreased in turn.There were significant differences in pairs in each group(all P<0.05).Correlation analysis showed that LASI was positively correlated with cTnT,Myo,NT-proBNP,Urea,Scr and Cys-C(r=0.581,0.487,0.601,0.443,0.517,0.572,all P<0.001),and negatively correlated with eGFR(r=-0.577,P<0.001).Multiple linear regression analysis showed that after adjusting for BMI,age,gender,hypertension,diabetes and other influencing factors,NT-proBNP,Urea,Scr,eGFR,Cys-C were still independently correlated with LASI(all P<0.05).The repeatability test showed that the repeatability of LASr and LASI within intra-observer and inter-observer were good(intra-observer ICC=0.992,0.975,inter-observer ICC=0.995,0.985).Conclusion LASI can be used as an effective index for evaluating left atrial function in patients with different stages of CKD,with its value increasing as CKD progresses.
作者
高雪
肖为为
何垚
姬莉芹
于绍梅
GAO Xue;XIAO Weiwei;HE Yao;JI Liqin;YU Shaomei(School of Medical Imagine,Guizhou Medical University,Guiyang 550004,China)
出处
《临床超声医学杂志》
CSCD
2023年第10期785-790,共6页
Journal of Clinical Ultrasound in Medicine
基金
2021年贵州省卫生健康委科学技术基金项目(gzwkj2021-383)
贵州医科大学附属医院博士科研启动基金项目(gyfybsky-2021-19)。
关键词
超声心动描记术
慢性肾脏病
左房僵硬度指数
心房功能
左
Echocardiography
Chronic kidney disease
Left atrial stiffness index
Atrial function,left
