摘要
【目的】探讨早期慢性肾脏病(CKD)患者的血清白蛋白水平与冠脉钙化(CAC)的相关性,以及对CAC发生及严重程度的预测价值。【方法】筛选2019年1月至2022年12月于中山大学孙逸仙纪念医院住院行冠状动脉CTA检查的早期CKD患者391例,收集一般临床资料、血清学检查结果、冠脉CTA检查结果。根据冠脉钙化积分(CACS)将患者分为非冠脉钙化组(CACS=0分)184例,冠脉钙化组(CACS>0分)207例;根据血清白蛋白水平分为三组,即白蛋白<35 g/L组(30例)、35 g/L≤白蛋白<40 g/L组(198例)、白蛋白≥40 g/L组(163例)。首先利用单因素及多因素回归方法分析血清白蛋白对早期CKD患者CAC的影响,其次对不同CAC程度患者中进行组内差异性分析、组间多重比较、logistics回归模型分析。【结果】冠脉钙化组患者的血清白蛋白水平显著低于非冠脉钙化组(P<0.05)。在早期CKD患者中血清白蛋白水平与CACS呈负相关(P<0.01),即血清白蛋白水平越低,CAC程度越严重。【结论】在早期CKD患者中,血清白蛋白水平越低,CAC发生率越高。并且低血清白蛋白水平是CAC进展的独立危险因素。
【Objective】To explore the correlation between serum albumin levels and coronary artery calcification(CAC)in patients with early-stage chronic kidney disease(CKD),as well as the value of serum albumin levels in predict⁃ing the incidence and severity of CAC.【Methods】The study included 391 early-stage CKD patients who underwent coro⁃nary computed tomography angiography(CTA)at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between Jan⁃uary 2019 and December 2022.Demographic and biochemistry data,as well as the coronary CTA results,were collected.Based on the coronary artery calcification score(CACS),all patients were divided into non-CAC group(CACS=0,n=184)and CAC group(CACS>0,n=207).All patients were further divided into 3 groups based on the serum albumin levels:group A(serum albumin levels<35 g/L,n=30),group B(35 g/L≤serum albumin levels<40 g/L,n=198)and group C(serum albumin levels≥40 g/L,n=163).Univariate and multivariate binary logistic regression analyses were conducted to investigate the association between serum albumin levels and CAC in early-stage CKD patients.Differences in CAC among groups were analyzed by using post-hoc multiple comparisons and ordinal logistic regression model analysis.【Re⁃sults】Patients with CAC had significantly lower serum albumin levels than those without CAC(P<0.05).There was a nega⁃tive correlation between serum albumin levels and CACS in early-stage CKD patients(P<0.01),as serum albumin de⁃creased in levels,CAC increased in severity.【Conclusions】Our study shows that early-stage CKD patients with lower se⁃rum albumin levels have a higher incidence of CAC.Low serum albumin level is an independent risk factor for CAC pro⁃gression.
作者
麦培彪
黄晟文
张坤
伍卫
罗年桑
MAI Peibiao;HUANG Shengwen;ZHANG Kun;WU Wei;LUO Niansang(Department of Cardiology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510000,China;Department of Cardiology,The Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen 518000,China;Department of Cardiology,Meizhou People’s Hospital,Meizhou 514031,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2024年第2期268-275,共8页
Journal of Sun Yat-Sen University:Medical Sciences
基金
国家自然科学基金(81600351)。
关键词
慢性肾脏病
动脉粥样硬化
冠状动脉钙化
血清白蛋白
肾小球滤过率
危险因素
chronic kidney disease(CKD)
atherosclerosis
coronary artery calcification(CAC)
serum albumin
glomerular filtration rate
risk factors
