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高摄入量和液体过预测慢性病中心脏结构和功能障碍
Suyan Duan1, Yuchen Ma1, Fang Lu1
1Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
Frontiers in nutrition
|June 11, 2024
概括
高摄入量和流体过载显著增加慢性病 (CKD) 患者的心脏功能障碍的风险. 将这些因素与eGFR和蛋白尿结合起来,可以改善风险预测,从而更好地管理患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 高摄入量和流体过载在慢性病 (CKD) 中很普遍.
- 它们对非透析CKD患者心脏功能障碍的具体影响仍然不完全理解.
研究的目的:
- 研究每日盐摄入量 (DSI) 和细胞外水与全体水比 (ECW/TBW) 对非透析CKD患者心脏变化的影响.
- 评估DSI,ECW/TBW,eGFR和蛋白尿对心脏功能障碍的综合预测值.
主要方法:
- 409名非透析的CKD患者 (G1-G4阶段) 根据DSI (>6g/天) 和ECW/TBW比率 (>0.439) 进行分类.
- 分析了心声学参数,身体组成和临床指标.
- 使用后勤和考克斯回归模型来确定与左心室缩 (LVH) 和左心室填充压力升高 (ELVFP) 的关联.
主要成果:
- 与低DSI和低ECW/TBW患者相比,高DSI和高ECW/TBW患者的LVH和/或ELVFP风险增加了2.396倍.
- DSI和ECW/TBW的组合预测了心脏功能障碍,AUC为0.704,在脏病患者的蛋白尿症下改善到0.713.
- 估计的淋巴细胞过率 (eGFR) 和蛋白尿增加了风险分层的准确性.
结论:
- 每日高盐摄入量和高细胞外水分独立预测非透析CKD患者心脏功能障碍 (LVH或ELVFP) 的风险增加.
- 将EGFR和蛋白尿与DSI和ECW/TBW整合起来,可以改善CKD患者心脏功能障碍风险分层.
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