摘要
目的 评估预后营养指数(PNI)联合C反应蛋白/白蛋白比值(CAR)、血清白蛋白(Alb)对腹膜透析(PD)患者远期预后的预测价值。方法 分析纳入2019年1月至2024年1月在自贡市第一人民医院肾病内科接受PD治疗的终末期肾病患者102例,根据5年随访期间PD患者生存结局分为死亡组(n=33)和生存组(n=69)。采用单因素及多因素Logistic回归分析影响PD患者远期预后的独立危险因素。绘制受试者工作特征(ROC)曲线评估PNI联合CAR、Alb对PD患者生存结局的预测价值。结果 与生存组相比,死亡组患者合并糖尿病、心血管疾病及腹膜炎并发症的比例较高,差异有统计学意义(χ^(2)=0.947,4.846,5.840);肾小球滤过率(eGFR)、PNI、Alb水平降低,差异有统计学意义(t=9.495,6.068,5.422);血清肌酐(SCR)、尿酸(UA)及CAR水平升高,差异有统计学意义(t=5.369,4.581,5.048),差异均有统计学意义(P<0.05)。Logistic回归分析显示,患者合并糖尿病、心血管疾病、CAR是PD患者死亡的独立危险因素(P<0.05),eGFR、PNI、Alb是PD患者死亡的独立保护因素(P<0.05)。ROC曲线分析显示,PNI、CAR、Alb联合预测的曲线下面积分别为0.928,显著高于单独预测(P<0.05)。结论 PNI、Alb水平降低及CAR升高是PD患者死亡的独立影响因素,三者均可为PD患者长期预后生存结局提供参考,且联合预测价值更高。
Objective To assess the predictive value of the prognostic nutritional index(PNI)in combination with the C-reactive protein/albumin ratio(CAR)and serum albumin(Alb)for the long-term prog-nosis of peritoneal dialysis(PD)patients.Methods In a retrospective analysis,102 end-stage renal disease pa-tients who underwent peritoneal dialysis(PD)treatment at the Nephrology Department of the First Peoples Hospital of Zigong City from January 2019 to January 2024 were included.Based on the 5-year follow-up pe-riod,PD patient survival outcomes were categorized into a deceased group(n=3)and a surviving group(n=69).Univariate and multivariate logistic regression analyses were employed to identify independent risk factors affecting the long-term prognosis of PD patients.Receiver Operating Characteristic(ROC)curves were gener-ated to assess the predictive value of combining the Prognostic Nutritional Index(PNI)with the C-reactive pro-tein/albumin ratio(CAR)and serum albumin(Alb)for PD patient survival outcomes.Results Compared to the survival group,the mortality group had a higher proportion of patients with diabetes,cardiovascular dis-eases,and complications of peritonitis(χ^(2)=0.947,4.846,5.840).The levels of glomerular filtration rate(eGFR),Prognostic Nutritional Index(PNI),and albumin(Alb)were lower(t=9.495,6.068,5.422).The levels of serum creatinine(SCR),uric acid(UA),and C-reactive protein to albumin ratio(CAR)were higher(t=5.369,4.581,5.048),with all these indicators showing statistically significant differences(P<0.05).Ac-cording to logistic regression analysis,the presence of diabetes,cardiovascular diseases,and an increased CAR were identified as independent risk factors for mortality in PD patients(P<0.05).Conversely,higher eGFR,PNI,and Alb levels were recognized as independent protective factors against mortality in PD patients(P<0.05).ROC curve analysis revealed that the combined prediction of PNI,CAR,and Alb had a significantly higher area under the curve(0.928)compared to individual predictions(P<0.05).Conclusio
作者
刘文佳
颜胜
陈越
LIU Wenjia;YAN Sheng;CHEN Yue(Department of Nephrology,the First People's Hospital of Zigong City,Zigong,Sichuan,China,643000)
出处
《分子诊断与治疗杂志》
2024年第6期1044-1048,共5页
Journal of Molecular Diagnostics and Therapy
基金
四川省医学科研课题项目(S18070)。
