摘要
目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者并发心脑血管疾病的相关危险因素。方法将2014年2月至2016年4月于本院行MHD的288例患者纳入MHD组,所有患者均接受持续≥3个月的透析治疗,其中108例患者并发心脑血管疾病,180例患者未并发心脑血管疾病。选取同期本院健康体检者100例纳入对照组。采用酶联免疫吸附测定检测所有研究对象五聚素3(pentraxin 3,PTX3)水平,采用Logistic回归分析分析MHD组患者的年龄、性别、有无吸烟史和糖尿病病史、透析龄、血压、血清白蛋白、血清前白蛋白、体重指数(body mass index,BMI)、透析前血肌酐(serum creatinine,Scr)、透析前血尿素氮(blood urea nitrogen,BUN)、转铁蛋白、铁蛋白、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、血红蛋白(hemoglobin,Hb)、心肌肌钙蛋白T(cardiac troponin T,c Tn T)水平与MHD患者并发心脑血管疾病的相关性。结果 MHD组患者透析前后血浆PTX3水平均明显高于对照组(P<0.05),MHD组患者透析后血浆PTX3水平明显高于透析前(P<0.05)。Logistic多因素回归分析显示,年龄>60岁、有吸烟史、透析龄>20天、c Tn T水平>0.047 ng/ml及PTX3水平>1.88 ng/ml是MHD患者并发心脑血管疾病的独立危险因素(P<0.05)。结论年龄>60岁、有吸烟史、透析龄>20个月、c Tn T>0.047 ng/ml及PTX3>1.88 ng/ml是MHD患者并发心脑血管疾病的独立危险因素,针对此类患者应引起临床重视。
Objective To investigate the risk factors of cardiovascular and cardiovascular disease in main- tenance hemodialysis （MHD） patients. Method A total of 288 patients with MHD from February 2014 to April 2016 in our hospital were enrolled into MHD group. All patients underwent sustained dialysis for 〉~ 3 months, of which 108 patients with cardiovascular and cerebrovascular diseases, 180 cases not complicated with cardiovascular and cerebrovascular diseases. A total of 100 healthy subjects were enrolled into control group. The levels of pentraxin 3 （PTX3） were detected by enzyme-linked immunosorbent assay （ELI SA）. Logistic regression analysis was used to analyze the correlations between vascular disease and age, sex, smoking history, history of diabetes, dialysis age, blood pressure, serum albumin, serum prealbumin, body mass index （BMI）, serum creatinine （Scr）, blood urea nitrogen （BUN）, transferrin, ferritin, triglyceride （TG）, total cholesterol （TC）, low density lipoprotein cholesterol-cholesterol （LDL-C）, high density lipoprotein-cholesterol （HDL-C）, hemoglobin （Hb）, cardiac troponin T （cTnT） and MHD. Result Before and after dialysis, plasma PTX3 levels in MHD patients after dialysis were significantly higher than those in control group （P 〈 0.05）. Plasma PTX3 levels in MHD patients after dialysis were significantly higher than those before dialysis （P 〈 0.05）. Logistic multivariate regression analysis showed that the age 〉 60 years old, smoking history, dialysis age 〉 20 days, cTnT level 〉 0.047 ng/ml and PTX3 level 〉 1.88 ng/ml were risk factors for cardiovascular and cerebrovascular diseases （P 〈 0.05）. Conclusion The age 〉 60 years old, with smoking history, dialysis age 〉 20 days, cTnT level 〉 0.047 ng/ml and PTX3 level 〉 1.88 ng/ml are the independent risk factors for cardiovascular andcerebrovascular diseases in MHD patients. Thus, attentions need to be paid on these patients.
出处
《中国医学前沿杂志（电子版）》
2017年第3期85-88,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
维持性血液透析
心脑血管疾病
危险因素
炎症
慢性病贫血
Maintenance hemodialysis
Cardiovascular and cerebrovascular diseases
Risk factors
Inflammation
Chronic anemia
