矿物元素及炎症因子水平对慢性肾衰竭患者并发脑血管疾病的预测价值

Predictive value of mineral elements and inflammatory factors in patients with chronic renal failure complicated with cerebrovascular disease

目的 :明确矿物元素及炎症因子水平对慢性肾衰竭患者发生脑血管疾病事件的预测价值。方法 :连续性收集2016年1月~2020年6月间我院肾脏内科病房的慢性肾脏衰竭患者共389例,其中并发脑血管疾病患者236例作为研究组,未并发脑血管疾病患者153例作为对照组。采集两组患者静脉血作为检验样本,每个月检测血清中炎症因子和矿物元素指标水平并记录,为期12个月,最终各项数据取随访期间各项检查指标结果的平均值。将所检各指标纳入单因素分析和Logistic回归分析,最终筛选出影响慢性肾衰竭脑血管病发生的独立危险因素,并分析炎症因子和矿物元素与脑血管病发生的相关性。结果 :单因素分析结果显示,研究组动脉粥样硬化发生率高于对照组;IL-1、IL-6、TNF-α、Ca、P高于对照组;Mg、Se、Zn、Cu、Mn低于对照组。两组患者在年龄、性别构成、慢性肾衰竭病程以及原发病构成上无显著差异。多因素回归分析结果显示,IL-1、IL-6、TNF-α、Ca、P、Mg、Se、Zn、Cu、Mn均为慢性肾衰竭患者脑血管病发生的独立危险因素,且与其显著相关。结论 :慢性肾衰竭患者血液中相关炎症因子以及矿物元素,与脑血管疾病和动脉粥样硬化发生率呈显著相关,对慢性肾衰竭并发脑血管疾病有预测价值,并推测可用于慢性肾衰竭相关脑血管疾病的风险分层和作为潜在的治疗靶点。

Objective To determine the predictive value of mineral elements and inflammatory factors on cerebrovascular disease events in patients with chronic renal failure. Methods A total of 389 patients with chronic renal failure in the department of nephrology of our hospital from January 2016 to June 2020 were continuously collected, including 236 patients with cerebrovascular disease as the study group, 153 patients without cerebrovascular disease as the control group. Venous blood of patients in both groups was collected as test samples, and the levels of inflammatory factors and mineral elements in serum were detected and recorded every month for 12 months. The final data were taken as the average of the results of various examination indicators during the follow-up period. All the indexes were included in univariate analysis and logistic regression analysis to screen out the independent risk factors of CVD, and analyze the correlation between inflammatory factors and mineral elements and CVD. Results Univariate analysis showed that the incidence of atherosclerosis in study group was higher than that in control group. Il-1, IL-6, TNF-α, Ca and P were higher than those in control group. Compared with control group, Mg, Se, Zn, Cu and Mn decreased. There were no significant differences in age, gender composition, chronic renal failure course and primary disease composition between 2 groups. Multivariate regression analysis showed that IL-1, IL-6, TNF-α, Ca, P, Mg, Se, Zn,Cu, Mn were independent risk factors for cerebrovascular disease in patients with chronic renal failure. Conclusion Patients with chronic renal failure related inflammatory factor and mineral elements in the blood, and cerebrovascular disease and significantly correlated to the incidence of atherosclerosis, has predictive value to the chronic renal failure complicated with cerebrovascular disease, and speculated that can be used in the risk stratification of chronic renal failure related to cerebrovascular disease and as potential therapeutic targets.