摘要
目的评估维持性血液透析(maintenance hemodialysis,MHD)患者心脏瓣膜钙化(cardiac valve calcification,CVC)与自体动静脉内瘘(arteriovenous fistula AVF)失功之间的关系。方法收集2019年6月~2020年12月在北京市海淀医院行MHD的患者,共95例。收集其一般资料及实验室检查数据,同时用多普勒超声评估患者心脏瓣膜钙化程度并分为无、轻、中、重度4个等级。无和轻度钙化视为轻度钙化组,中度和重度钙化视为重度钙化组,分析CVC相关的临床因素和AVF失功之间的关系。结果MHD患者随着年龄增长,瓣膜钙化程度逐渐加重(t=2.463,P<0.016);与轻度CVC组相比,重度CVC组患者血磷(t=-4.075,P<0.001),甲状旁腺激素(t=-3.398,P<0.001)增高;血浆前白蛋白降低(t=-2.412,P=0.018)。多因素回归分析显示CVC重度钙化是内瘘失功的独立危险因素,重度CVC组患者发生内瘘失功的危险性是轻度CVC组的4.909倍(95%CI:1.972~12.222,P=0.001)。结论年龄、高血磷、高甲状旁腺激素以及低前白蛋白水平是瓣膜钙化的危险因素,重度CVC可预测内瘘失功风险。
Objective To evaluate the relationship between cardiac valve calcification(CVC)and failure of arteriovenous fistula(AVF)in patients with maintenance hemodialysis(MHD).Methods A total of 95 MHD patients treated at Beijing Haidian Hospital from June 2019 to December 2020 were recruited.Their clinical data and laboratory results were collected.The extent of CVC by color Doppler ultrasonography was classified into four(none,slight,medium,heavy)grades.Patients were then divided into minor CVC group(patients with none or slight CVC)and severe CVC group(patients with medium or heavy CVC).The association between CVC severity,clinical factors,and failure of AVF was then analyzed by Cox proportional hazard analysis.Results The severity of CVC increased along with the increase of age(t=2.463,P<0.016).Serum phosphate(t=-4.075,P<0.001)and parathyroid hormone(t=-3.398,P<0.001)were higher and prealbumin(t=-2.412,P=0.018)was lower in severe CVC group as compared with those in minor CVC group.Multivariate regression analysis showed that severe CVC was the independent risk factor for failure of AVF,and the risk for failure of AVF in severe CVC patients was 4.909 times higher than that in minor CVC patients(OR=4.909,95%CI:1.972~12.222,P=0.001).Conclusions Older age,higher serum phosphate,parathyroid hormone and TG,and lower serum prealbumin were the risk factors for CVC.Severe CVC can be used to predict the failure of AVF in MHD patients.
作者
赵彬
詹申
侯方
张丽红
王玉柱
ZHAO Bin;ZHAN Shen;HOU Fang;ZHANG Li-hong;WANG Yu-zhu(Department of nephrology,Haidian Hospital,Peking University Third Hospital,Beijing 100080,China)
出处
《中国血液净化》
CSCD
2022年第1期51-54,共4页
Chinese Journal of Blood Purification
关键词
维持性血液透析
心脏瓣膜钙化
动静脉内瘘
相关性
Maintenance hemodialysis
Cardiac valve calcification
Failure of arteriovenous fistula
Relationship
