Martínez-Quintana Efrén, Rodríguez-González Fayna, Fábregas-Brouard Marian, Nieto-Lago Vicente
Cardiology Service, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain.
Congenit Heart Dis. 2009 May-Jun;4(3):147-52. doi: 10.1111/j.1747-0803.2009.00273.x.
Glomerulopathy is a complication of congenital heart disease patients. The risk of developing renal impairment is particularly high in cyanotic patients.
The aim of this study was to determine the prevalence of renal dysfunction and microalbumiuria in adult cyanotic and non cyanotic congenital heart disease patients.
Fourteen cyanotic and 22 noncyanotic congenital heart disease patients were studied in the Adult Congenital Heart Disease Unit at the Complejo Hospitalario Universitario Insular-Materno Infantil. Demographic characteristics, complete blood count, and 24-hour urianalysis were obtained, including abdominal ultrasound in those with cyanosis.
No differences were seen between age (years) (27.4 +/- 8.2; 26.4 +/- 8.3; P = .71), sex, size, weight, or glomerular filtration rate (mL/min/1.73 m(2)) (81.1 +/- 22.9 vs. 84.9 +/- 9.2, P = .482) between cyanotic and noncyanotic patients. However, Eisenmenger patients had significantly impaired renal function when compared with noncyanotic patients (73.0 +/- 17.3 vs. 84.9 +/- 9.2 mL/min/1.73 m(2), P = .023). Significant differences were obtained in oxygen saturation (%) (83.8 +/- 5.8 vs. 97.8 +/- 0.8; P = .000), hematocrit (%) (59.3 +/- 8.1 vs. 40.9 +/- 8.5; P = .000), platelets (10(3)/microL) (161.5 +/- 70.5 vs. 277.9 +/- 57.6; P = .000), serum uric acid (mg/dL) (7.5 +/- 2.3 vs. 5.6 +/- 1.5; P = .008) and microalbuminuria (mg/24 hours) (12.8 [0, 700.2] vs. 2.4 [0, 18.9]; P = .000) between cyanotic and noncyanotic patients. Five cyanotic patients (35.7%) had microalbuminuria (>30 mg/24 hours) and three of them (21.4%) proteinuria (>1 g/24 hours). No significant differences were seen between serum and urine parameters between cyanotic patients who had microalbuminuria (>30 mg/24 hours) and those cyanotic patients who did not have it (<30 mg/24 hours).
Renal impairment is frequently seen in congenital heart disease patients, being associated occasionally with proteinuria and microalbuminuria in cyanotic ones.
肾小球病是先天性心脏病患者的一种并发症。青紫型患者发生肾功能损害的风险尤其高。
本研究的目的是确定成年青紫型和非青紫型先天性心脏病患者肾功能不全和微量白蛋白尿的患病率。
在海岛-母婴大学综合医院的成人先天性心脏病科对14例青紫型和22例非青紫型先天性心脏病患者进行了研究。获取了人口统计学特征、全血细胞计数和24小时尿液分析结果，对青紫型患者还进行了腹部超声检查。
青紫型和非青紫型患者在年龄（岁）（27.4±8.2；26.4±8.3；P = 0.71）、性别、身高、体重或肾小球滤过率（mL/min/1.73 m²）（81.1±22.9对84.9±9.2，P = 0.482）方面没有差异。然而，与非青紫型患者相比，艾森曼格综合征患者的肾功能明显受损（73.0±17.3对84.9±9.2 mL/min/1.73 m²，P = 0.）。青紫型和非青紫型患者在血氧饱和度（%）（83.8±5.对97.8±0.；P = 0.）、血细胞比容（%）（59.3±8.对40.9±8.；P = 0.）、血小板（10³/μL）（161.5±70.对277.9±57.；P = 0.）、血清尿酸（mg/dL）（7.5±2.对5.6±1.；P = 0.）和微量白蛋白尿（mg/24小时）（12.8 [0, 700.2]对2.4 [0, 18.9]；P = 0.）方面存在显著差异。5例青紫型患者（35.7%）有微量白蛋白尿（>30 mg/24小时），其中3例（21.4%）有蛋白尿（>1 g/24小时）。有微量白蛋白尿（>30 mg/24小时）的青紫型患者与无微量白蛋白尿（<30 mg/24小时）的青紫型患者在血清和尿液参数方面没有显著差异。
先天性心脏病患者常出现肾功能损害，青紫型患者偶尔会伴有蛋白尿和微量白蛋白尿。
