持续性非卧床腹膜透析对颈动脉中膜厚度的影响

Influencing factors of carotid intima-media thickness in continuous ambulatory peritoneal dialysis patients

目的 探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)对颈动脉中膜厚度(carotid intima-media thickness,CIMT)的影响。方法 选择2015-01至2019-01医院收治的CAPD患者96例为研究对象,采用彩色多谱勒超声测定CIMT,根据CIMT不同分为两组:增厚组CIMT≥1. 0 mm,正常组CIMT <1. 0 mm,观察两组患者血磷(P)、超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)等指标差异。结果 CAPD患者中CIMT增厚的检出率为45. 83%。单因素分析显示两组间患者年龄、糖尿病患数、血磷、hs-CRP、IL-6、TNF-α水平差异有统计学意义(P <0. 05),多因素回归分析结果显示CAPD患者的血磷(P=0. 003,OR=1. 113)、hs-CRP (P=0. 001,OR=1. 148)、IL-6(P=0. 016,OR=1. 056)是CIMT增厚的独立危险因素。结论 CAPD患者中CIMT增厚与血磷、hs-CRP、IL-6等因子有关,是CAPD患者出现血管钙化,进而出现心血管事件并发症的重要危险因素。

Objective To explore the influencing factors of carotid intima-media thickness in continuous ambulatory peritoneal dialysis patients.Methods The continuous ambulatory peritoneal dialysis(CAPD)patients were divided into the increased CIMT group(CIMT≥1.0 mm)and normal CIMT group(CIMT<1.0 mm)based on their carotid color Doppler ultrasound results.The relationships between serum phosphorous,hs-CRP,IL-6 and the increased CIMT were analyzed in the two groups.Results The proportion of the increased CIMT in CAPD patients was 45.83%.The differences in age,numbers of diabetes mellitus patients,serum phosphorous,hs-CRP,IL-6 and TNF-α between the two groups were statistically significant(P<0.05).Multivariate logistic regression analysis showed that serum phosphorous(P=0.003,OR=1.113),hs-CRP(P=0.001,OR=1.148)and IL-6(P=0.016,OR=1.056)were significant independent risk factors for the increased CIMT in CAPD patients.Conclusions The thickening of CIMT in CAPD patients is related to serum phosphorous,hs-CRP,IL-6 and other factors,which is an important risk factor for the occurrence of vascular calcification and cardiovascular complications in CAPD patients.