| Objective: Cardiovascular disease and chronic kidney disease as a serious threat to human health disease,Cardiovascular disease is chronic kidney disease patients,especially for patients with end-stage renal disease,the most common complications,and the first cause.Vascular calcification can lead to end-stage renal disease in patients with cardiovascular events,and even serious fatal cardiovascular diseases such as heart failure,myocardial infarction.Uremia induced the changes in cardiac structure and function closely related to cardiovascular disease.Therefore,this topic is to investigate the uremia patients with vascular calcification,and the relationship between the cardiac structure and function,Providing the basis for clinical prevention and treatment of secondary heart disease.Method: We selected 61 uremic patients who were hospitalized from March 2014 to December 2015,in Dalian medical university.Inclusion criteria:(1)Conform to the United States in 2002 K/DOQI CKD definition,according to a MDRD formula of e GFR,the patients to 5 stage.(2)agree that the research plan and signed informed consent.Exclusion criteria:(1)malignant tumor;(2)with severe hepatic insufficiency;(3)not to cooperate to complete inspectors;(4)merger of congenital heart disease,severe arrhythmia,coronary artery bypass,or stent implantation;(5)portal hypertension,pulmonary vein occlusion,pulmonary embolism,chronic obstructive pulmonary disease.Collect the patient's general data and laboratory test b-type brain natriuretic peptide(BNP),serum Cre,BUN,ALB,Ca,P,TG,TC,HB,LDL-C of them were detected at the same time.By cardiac color ultrasound examination,calculate the left ventricular muscle weight index;With tricuspid reflux,according to Bernoulli equation calculating the pulmonary artery pressure;By coronary CT scan,calculation of coronary artery calcium score(CACS);By abdominal CT scan,abdominal aortic calcification index(AACI).Use SPSS13.0 software for data analysis.The data was analyzed by SPSS.13.0 software.Differences between mean values of two groups were assessed t-test;Differences between multiple groups were used one-way ANOVA.Pearson's correlation coefficient was used to test the association between two kinds of parameters.P<0.05 was considered statistically significant.Results: 42 cases of uremic patients both used coronary CT and cardiac color ultrasound,Coronary artery calcification between the positive and negative groups,IVS(11.77±1.18 vs 10.50±1.10)mm,LVPW(11.77±1.18 vs 10.50±1.10)mm,LAD(39.38±5.10 vs 36.06±3.24)mm,LVMI(135.16±29.97 vs 113.31±26.49)g/m~2,PASP(37.29±8.91vs30.55±3.30)mm Hg,BNP(624.48±450.98 vs184.60±174.44)pg/mg were significantly higher(p<0.05);LVEF(53.19±7.18 vs57.25±3.28)%were obviously lower(p<0.05);According to the coronary calcification score graded,Moderate calcification group compared with negative group,IVS(12.30±0.82 vs 10.50±1.10)mm,LVPW(12.30±0.82 vs 10.50±1.10)mm,LVMI(142.61±33.57 vs 113.31±26.49)g/m~2,LVDd(53.40±7.12 vs 48.50±5.02)mm and LAD(40.70±5.79 vs 36.06±3.24)mm were significantly higher(p<0.05);Moderate calcification group compared with slight calcification group,IVS(12.30±0.82 vs 11.09±1.14)mm,LVPW(12.30±0.82 vs 11.09±1.14)mm and LVMI(142.61±33.57 vs 118.47±24.32)g/m~2 were significantly higher(p<0.05);Moderate calcification group compared with negative group and slight calcification group,LVEF(49.60±10.29 vs 57.25±3.28?55.55±3.50)% were obviously lower(p<0.05);Severe calcification group compared with negative group,IVS(12.20±1.30 vs 10.50±1.10)mm,LVPW(12.20±1.30 vs 10.50±1.10)mm and LVMI(156.94±10.04 vs 113.31±26.49)g/m~2 were significantly higher(p<0.05);Severe calcification group compared with slight calcification group,LVMI(156.94±10.04 vs 118.47±24.32)g/m~2 were significantly higher(p<0.05);In 48 uremic patients,who also received whole abdominal CT scans and cardiac color ultrasound,abdominal aortic calcification positive group compared with negative group,LVMI(134.87±26.66 vs113.69±22.47)g/m~2 were significantly higher(p<0.05);According to the degree of abdominal aortic calcification grouping,moderate calcification group compared with negative group,LVMI(142.14±30.10 vs 113.69±22.47)g/m~2,LAD(41.82±4.38 vs 38.88±4.52)mm were significantly higher(p<0.05);moderate calcification group compared with slight calcification group,LVMI(142.14±30.10 vs 120.58±23.31)g/m~2 were significantly higher(p<0.05);Severe calcification group compared with negative group,LVMI(142.88±22.65 vs 113.69±22.47)g/m~2 were significantly higher(p<0.05);Severe calcification group compared with slight calcification group,LVMI(142.88±22.65 vs 120.58±23.31)g/m~2 were significantly higher,LVEF(49.73±10.32 vs56.57±4.75)%were obviously lower(p<0.05).Hypertension group compared with non-hypertension group,IVS(11.85±1.40 vs 10.50±1.02)mm,LVPW(11.79±1.40 vs10.57±1.02)mm,LAD(38.62±4.79 vs 37.21±5.09)mm,and LVMI(134.04±28.13 vs114.22±32.02)g/m~2 were significantly higher(p<0.05);Diabetes group compared with non-diabetic group,IVS(12.15±1.43 vs 11.09±1.27)mm,LVPW(12.12±1.37 vs 11.06±1.28)g/m~2 and BNP(889.09±663.29 vs 297.68±309.26)were significantly higher(p<0.05).Correlation analysis showed,CACS was significantly positively correlated with IVS(r=0.442,p=0.04),LVPW(r=0.442,p=0.04)and LVMI(r=0.402,p=0.009).AACI was significantly positively correlated with LVMI(r=0.338,p=0.019).The significant negative correlations of LVEF(r=-0.293,p=0.043)and AACI were found.Conclusions: LVMI of uremia coronary artery calcification positive group and abdominal aortic calcification positive group was significantly higher than negative group,and increased with the degree of coronary artery calcification,LVEF of uremia coronary artery calcification positive group was significantly lower than negative group;Uremia CACS,AACI with LVMI were both significantly positive correlation. |
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