摘要
目的:探讨慢性肾脏病(chronic kidney disease,CKD)非透析患者高敏肌钙蛋白I(hypersensitive troponin I,hs-cTn I)水平的相关影响因素,为早期筛选、识别慢性肾脏病患者中的心血管事件危险人群提供帮助.方法:单中心回顾性分析解放军某医院2018年01月—2019年01月期间住院诊断为CKD的非透析患者256例,将患者以hs-cTnI浓度0.034 ng/mL为界限分为hs-cTnI正常组(n=183)和hs-cTnI升高组(n=73),比较两组患者一般资料及实验室指标[血肌酐(Scr)、心肌酶、血尿素氮(BUN)、同型半胱氨酸、β2微球蛋白、高敏C反应蛋白、甲状旁腺素(PTH)、hs-cTn I],每位患者都进行心脏彩超检查,分析患者的hs-cTn I相关影响因素.结果:两组患者冠心病病史、收缩压、肾小球滤过率(eGRF)、Scr、BUN、β2微球蛋白、PTH、血磷(P)、血红蛋白(Hb)、左心室质量指数(LVMI)、N-末端脑钠肽前体(NT-proBNP)比较差异具有统计学意义;多元线性逐步回归分析结果显示冠心病病史、Hb、NT-proBNP、LVMI、P及PTH为hs-cTn I的影响因素,CKD非透析患者的冠心病病史,Hb降低,P、PTH、NT-pro BNP和LVMI的升高可引起hs-cTn I水平升高.结论:非透析CKD患者的冠心病病史、贫血、NT-proBNP升高、左室肥大、甲状旁腺亢进及高磷血症会引起hs-cTn I升高.
Objective To explore the related influencing factors of hs-cTnl level in non-dialysis patients with chronic kidney disease,and to provide help for early screening and identifiCation of Cardiovascular event risk groups in patients with chronic kidney disease.Methods A single-center retrospective analysis was performed on 256 non-dialysis patients diagnosed with CKD who were hospitalized in a certain hospital of the People's Liberation Army from January 2018 to January 2019.Patients were divided into normal hs-cTnl group(n=183)and elevated hs-cTnl group(n=73)with hs-cTnl concentration of 0.034 ng/mL.General data and laboratory indicators(serum creatinine,myocardial enzyme,blood urea nitrogen,homocysteine,β2 microglobulin,hypersensitive C-reactive protein,parathyroid hormone,hs-cTnl)were compared between the two groups.Color Doppler ultrasound was performed for each patient,and relevant statistical methods were used to analyze the affecting factors of hs-cTnl in the patients.Results There were statistically significant differences in coronary heart disease history,systolic blood pressure,eGRF,Scr,BUN,β2 microglobulin,PTH,P,hemoglobin(Hb),left ventricular mass index(LVMI)and N terminalpro brain natriuretic peptide(NT-proBNP)between the two groups.The results of multiple linear stepwise regression analysis showed that coronary heart disease history,Hb,NT-proBNP,LVMI,P and PTH were the influencing factors of hs-cTnI.The coronary heart disease history of non-dialysis patients with CKD showed a decrease in Hb.The increase of P,PTH,NT-pro BNP and LVMI Can lead to the increase of hs-cTn I level.Conclusion A history of coronary heart disease,anemia,elevated NT-proBNP,left ventricular hypertrophy,hyperparathyroidism,and hyperphosphatemia in non-dialysis CKD patients can cause hypersensitive troponin I to increase.
作者
刘思言
王湘川
LIU Siyan;WANG Xiangchuan(School of Medicine,Hunan Normal University,Changsha 410013,China;921st Hospital of the Joint Service and Security Force of the Chinese People's Liberation Army,Changsha 410022,China)
出处
《湖南师范大学学报（医学版）》
2023年第4期120-123,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
慢性肾脏病
高敏肌钙蛋白I
心血管风险
chronic kidney disease
hypersensitive troponin I
cardiovascular event
