透析患者的左侧膜心脏病:一个单中心观察性研究
Mohamed Elewa1, Sandip Mitra2, Anuradha Jayanti3
1Consultant Nephrologist, Manchester University NHS Foundation Trust, Manchester, UK.
Clinical kidney journal
|July 3, 2023
概括
膜心脏病 (VHD) 影响了近一半的透析患者,显著增加死亡风险. 大动脉狭窄 (AS) 独立地与这一群体的生存率下降有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 临床医学 临床医学
背景情况:
- 慢性病 (CKD) 的患病率正在上升,增加了置换治疗的需求.
- 在接受脏置换的CKD患者中,心血管死亡率不成比例地高.
- 末期脏病 (ESRD) 患者的膜心脏病 (VHD) 与较差的生存结果有关.
研究的目的:
- 确定透析患者中显著的VHD的患病率和特征.
- 在这个队列中调查VHD和临床参数之间的关联.
- 评估VHD对透析患者生存率的影响.
主要方法:
- 从521名英国透析接受者收集了心声学参数.
- 显著的左侧心脏病 (LSHD) 定义为中度/严重的膜病变,LVSD (EF <45%),或两者兼而有之.
- 人口统计和临床数据与心声回声学发现一起进行了分析.
主要成果:
- 46%的患者患有LSHD,包括VHD (34%),LVSD (12%),或两者 (14%).
- 高龄和cinacalcet使用与更高的VHD几率相关;酸盐结合剂与大动脉狭窄症 (AS) 有关.
- 对于VHD (78%) 和LSHD (78%) 的1年生存率低于对照组 (86-88%). AS显著降低了生存率 (64%).
结论:
- 临床显著的LSHD在透析患者中普遍存在,并与死亡率增加有关.
- 大动脉狭窄 (AS) 是透析患者死亡率较高的独立预测因素.
- 早期发现和治疗VHD对于改善ESRD人群的生存率至关重要.
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