摘要
目的分析血尿酸与血透患者全因死亡及心血管死亡之间的关系,探讨尿酸对血透患者长期生存的影响。方法回顾性分析并方便选取2016年1月—2017年12月期间该院血液净化中心血透患者265例,通过病历记录中获取相关临床资料,并检测相关实验室指标。按尿酸四分位值(374μmol/L,432μmol/L,493μmol/L)分为4组。观察主要结果为全因死亡,次要结果为心血管死亡,采用COX回归分析血尿酸与全因死亡及心血管死亡的关系。结果尿酸最低组,年老,女性偏多,透析时间短,合并有更低的体重指数,白蛋白、尿素氮、肌酐、血磷均较尿酸最高组明显降低,血红蛋白低于尿酸最高组。尿酸最低组的全因死亡率明显高于尿酸最高组[25.37%(17/67)vs 11.94%(8/67)](P<0.05),随着尿酸水平的升高,死亡率逐渐下降,但其他3组间死亡率差异无统计学意义。4组血透患者的心血管死亡率之间无明显差别。Cox回归模型发现低尿酸与高全因死亡明显相关,在校正多种混杂因素后仍明显相关,死亡风险比0.328[95%CI(0.122~0.886)],而尿酸与心血管死亡无相关。结论血尿酸与血透患者全因死亡明显相关,但心血管死亡除外。低尿酸血透患者生存率低,而高尿酸反应营养状态好,降低死亡风险。
Objective To analyze the associations of serum uric acid,all-cause and cardiovascular mortality risk in hemodialysis patients.To explore the impact of UA on long-term survival of hemodialysis patients.Methods This was a retrospective study involving 265 subjects who had undergone HD in the blood purification center of the hospital from January 2016 to December 2017 were convenient selected.The clinical data were collected through medical records and related laboratory indicators were tested.Divided into four groups according to the uric acid quartile value(374μmol/L,432μmol/L,493μmol/L).The main outcome was observed as all-cause death,and the secondary outcome was cardiovascular death.Cox regression models were used to evaluate the relationship between uric acid and all-cause,cardiovascular mortality.Results The lowest uric acid group tended to be older,had more females,shorter dialysis time,lower body mass index,albumin,urea nitrogen,creatinine and phosphorus were significantly lower than those of the highest uric acid group,and hemoglobin was lower than that of the highest uric acid group.The all-cause mortality rate of the lowest uric acid group was significantly higher than that of the highest uric acid group[25.37%(17/67)vs 11.94%(8/67)](P<0.05),With the increase of uric acid level,the mortality rate decreased gradually,but there was no significant difference in the statistics of mortality among the other three groups.There was no significant difference in cardiovascular mortality between the four groups of hemodialysis patients.Cox regression model found that low uric acid was significantly correlated with high all-cause mortality,but it was still significantly correlated after adjusting for a variety of confounding factors.The mortality risk ratio was 0.328[95%CI(0.122-0.886)],while uric acid was not correlated with cardiovascular mortality.Conclusion Serum uric acid is significantly associated with all-cause death in hemodialysis patients,except for cardiovascular death.Hemodialysis patients with low u
作者
钟晓容
杨枫
ZHONG Xiao-rong;YANG Feng(Department of Nephrology,Fuzhou First Hospital,Fuzhou,Fujian Province,350009 China)
出处
《中外医疗》
2019年第33期29-32,共4页
China & Foreign Medical Treatment
关键词
尿酸
死亡风险
血液
Uric acid
Mortality Risk
Hemodialysis
