摘要
目的观察维持性血液透析(MHD)患者主动脉弓钙化发生的情况,分析其中的相关因素。方法收集单个中心220例MHD患者胸部正位片,观察主动脉弓钙化的发生情况,检测血常规及血生化,并同患者的年龄、性别、原发病、MHD时间、血压、脉压、心胸比一起与主动脉弓钙化进行相关性分析,对有钙化组和无钙化组的上述指标进行对比。结果MHD220例主动脉弓发生钙化82例(37.3%),其中48例(58.50)在开始透析前就已存在主动脉弓钙化,34例(41.5%)在开始透析后出现,出现的时间为开始透析后7~48个月,平均(21.15±12.12)个月。钙化组的年龄(62.9±9.9)岁vs(50.8±12.9)岁(P〈0.01)、MHD时间(7.07±4.82)月vs(5.35±4.11)月(P〈0.05)、脉压(59.46±17.39)mmHg vs(51.79±12.26)mmHg(P〈0.01)、心胸比(0.52±0.06)vs(0.50±0.07)(P〈0.01)、球蛋白(25.15±5.77)g/L vs(23.33±5.22)g/L(P〈0.05)、钙磷乘积(4.43±1.45)vs(3.71±1.07)(P〈0.01)明显高于非钙化组,全段甲状旁腺激素(iPTH)(265.05±285.47)ng/L vs(384.03±390.88)ng/L(P〈0.05)、白蛋白(42.08±3.75)g/L vs(43.64±4.51)g/L(P〈0.05)明显低于非钙化组。MHD患者主动脉弓钙化的相关因素包括:年龄、透析前收缩压、舒张压、血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、钙磷乘积、iPTH。结论MHD患者发生主动脉弓钙化的几率很高,其中一半以上在透析时就早已发生。
Objective To overview the prevalence of aortic arch calcification in maintenance hemodialysis (MHD) patients,and analyse the correlation factors. Methods The chest X-ray images of 220 MHD patients in one unit were collected. The blood samples of MHD patients were tested before hemodialysis. Aortic arch calcification was noted. The age, gender, protopathy, MHD age, blood pressure including systobic blood pressure (SBP), diastolic blood pressure(DBP) ,mean arterial pressure,pulse pressure(PP) heart-breast ratio,hemoglobin,serum creatinine,blood urea nitrogen, calcium (Ca), phosphorus (P), Ca × P product, intact parathyroid hormone(iPTH), albumin (A), globulin (G), A/G,total cholesterol (TC), low-density lipoprotein (LDL-C) and triglyeride (TG) were tested with aortic arch calcification by logistic regression. The patients were divided into two groups according to with or without aortic arch calcification,and the parameters above were compared between two groups by independent t test or χ^2. Results There were 82 (37.3 %) MHD patients who had aortic arch calcification. The aortic arch calcification appeared at the beginning of hemodialysis in 48 patients (58.5 %, 48/82). The aortic arch calcification was found in other 34 patients since (21.15±12.12) months (7-48 months) from the beginning of hemodialysis. Age (62.95±9.9) years old vs (50.8± 12.9) years old( P 〈0.01) ,MHD age (7.07±4.82) years vs (5.35±4.11) years( P 〈0.05) ,PP (59. 46± 17.39) mm Hg vs 51. 79±12. 26) mmHg(P〈0.01),heart-breast ratio (0.52±0.06) vs (0.50±0.07)(P〈0.01),G (25.15± 5.77) g/L vs (23.33 ± 5.22) g/L( P 〈0.05) and Ca× P product (4.43± 1.45) vs (3.71 ± 1.07) ( P〈 0.01) in calcification group was higher than without calcification group,and A(42. 08±3.75) g/L vs (43.64±4.51) g/L( P〈0.05) ,iPTH(265. 05±285.47) ng/L vs (384. 03±390.88) ng/L( P 〈0.05) were significantly lower. The correlation factors of aortic arch calcification included : age, SBP, DBP, Hb, TC, TG, LDL-C, Ca × P product, iPTH.Conclusion There is high ratio of aortic arch calcification in MHD patients. Above half of the patients are found suffering from aortic arch calcification before entering into MHD period.
出处
《临床荟萃》
CAS
北大核心
2008年第24期1765-1769,共5页
Clinical Focus
关键词
肾功能衰竭
肾透析
主动脉
胸
kidney failure
renal dialysis
aorta, thoracic