慢性肾衰维持血液透析患者动脉粥样硬化危险因素分析

目的分析慢性肾衰维持血透(HD)患者动脉粥样硬化的危险因素。方法采用高分辨B型超声多谱勒方法测定慢性肾衰血透患者的双侧颈总动脉,如颈总动脉内膜厚度(IMT)≥0.90mm或出现粥样斑块者为阳性组,并对阳性和阴性两组的性别、年龄、平均维持血透时间、甲状旁腺激素(iPTH)、血脂等因素分别进行单因素及Logistic多因素回归分析。结果单因素分析结果提示阳性组29例与阴性组30例的年龄[(65.41±1.80)VS(55.13±2.05)岁,P<0.05)]、iPTH[(405.22±54.71)VS(200.05±17.38)pg/ml,P<0.05)]、钙磷乘积[(55.02±2.83)VS(45.32±1.71)mg/dl,P<0.05)],均有显著性差异,Logistic多因素回归分析亦发现年龄(P<0.01)、iPTH(P<0.015)、钙磷乘积(P<0.05),3者均有显著性差异。结论慢性肾衰维持血透患者发生动脉粥样硬化与年龄、iPTH、钙磷乘积等有关。

Objective To analyze risk factors associated with atherosclerosis in hemodialysis patients. Methods 59 cases were divided into positive group（atheromatous plaque or the IMT score ≥ 0.90mm） and negative group（no atheromatous plaque or the IMT score 〈 0.90mm）. Sexuality, age, hemodialysis duration, iPTH, blood - fat, calcium - phosphate product level between two groups were analyzed by Logistic multiple factor regression analysis. Results There are significantly difference in age, pare thyrosdism hormone level ,the calcium- phosphate product levelbetween two groups. Conchusion The old, the hyperphosphatemia, high calcium- phosphate product are the risk factors of atherosclerosis in maintenance hemodialysis patients with chronic renal failure.