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目的探讨慢性肾病患者血肌酐水平和心功能受损的相关性。方法比较68例慢性肾病患者(观察组)与60例健康志愿者(对照组)血肌酐(Scr)、心功能各项指标[左心室射血分数(LVEF)、血清乳酸脱氢酶(LDH)、血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)]、胰岛素抵抗各项指标[胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)]及内皮功能各项指标[外周血中内皮微粒(EMCs)、血管扩张反应(FMD)]检测结果。结果观察组患者者Scr、LDH、CK-MB、cTnT、cTnI、HOMA-IR和EMCs水平均显著高于对照组,LVEF、ISI和FMD水平显著低于对照组,差异均有统计学意义(P<0.05);Scr与LDH、CK-MB、cTnT、cTnI、HOMA-IR和EMCs水平呈正相关(r=2.917,r=3.093,r=2.285,r=1.340,r=3.488,r=3.102,P<0.05),与LVEF、ISI和FMD水平呈负相关(r=-1.051,r=-1.501,r=-2.352,P<0.05)。结论慢性肾病患者血肌酐水平异常升高与心功能受损、胰岛素抵抗以及内皮功能受损均有明显相关性,是诱发和加重心功能损害的重要危险因素。
Objective To investigate the correlation between serum creatinine and impaired cardiac function in patients with chronic kidney disease. Methods Serum creatinine (Scr), indexes of cardiac function (LVEF, LDL, LDH) were compared between 68 patients with CKD and 60 healthy volunteers (control group) (CK-MB, cTnT, cTnI), insulin resistance index (HOMA-IR), insulin sensitivity Index (ISI)] and endothelial function indicators [peripheral blood endothelial micro-particles (EMCs), vasodilatation (FMD)] test results. Results The levels of Scr, LDH, CK-MB, cTnT, cTnI, HOMA-IR and EMCs in the observation group were significantly higher than those in the control group. The levels of LVEF, ISI and FMD in the observation group were significantly lower than those in the control group <0.05). There was a positive correlation between Scr and levels of LDH, CK-MB, cTnT, cTnI, HOMA-IR and EMCs (r = 2.917, r = 3.093, r = 2.285, r = 1.340, r = 3.488, r = <0.05), but negatively correlated with LVEF, ISI and FMD (r = -1.051, r = -1.501, r = -2.352, P <0.05). Conclusion The abnormally elevated serum creatinine level in patients with chronic kidney disease is significantly associated with impaired cardiac function, insulin resistance and impaired endothelial function. It is an important risk factor for inducing and worsening cardiac dysfunction.