持续非卧床腹膜透析患者大动脉僵硬度影响因素分析

Related-factors of large arterial stiffness in continuous ambulatory peritoneal dialysis

目的探讨持续非卧床腹膜透析(CAPD)患者大动脉僵硬度的影响因素。方法选取241例CAPD患者为研究对象。大动脉僵硬度通过自动PWV分析仪检测颈股脉搏波速度(C-FPWV)进行评估,容量负荷用体成分分析仪(BCM,德国)测定,常规标准测量血压和尿酸、血白蛋白、C-反应蛋白、血肌酐、甘油三酯、胆固醇等相关生化指标。每个患者的指标均在同一天内常规测量。对相应指标行相关及多元回归分析,筛选出PWV的影响因素。结果显示PWV与糖尿病、年龄、收缩压、脉压、容量负荷相关。多元回归分析显示糖尿病(1=是,0=否β=0.307,P=0.001)]、年龄(β=0.329,P=0.001)、尿酸(β=0.274,P=0.001)、收缩压(β=0.188,P=0.002)、透析龄(β=0.129,P=0.027)是PWV增加的独立危险因素。结论除糖尿病、年龄、收缩压外,尿酸、透析龄也是影响腹膜透析患者大动脉僵硬度的独立危险因素。

Objective To investigate the factors affecting large arterial stiffness in patients with continuous ambulatory peritoneal dialysis（CAPD）.Methods Clinical stable CAPD patients（n=241）in a single center were enrolled in this study.Carotid-femoral PWV was measured with a validated automatic device and was used as an index for large arterial stiffness.The volume load was evaluated by a body composition monitor（BCM）.In addition,biochemical indices,such as blood pressure,serum uric acid,albumin,C-reactive protein,serum creatinine,serum triglycerides,and total cholesterol lipoprotein were determined with standard methods.Pearson＇s correlation and multiple regression analysis were performed to identify the relationship between related factors and PWV.Results PWV was strongly associated with diabetic mellitus（DM）,age,uric acid,systolic blood pressure（SBP）,pulse pressure,albumin,and extracellular water normalized by height.Multiple regression analysis showed that PWV was independently determined by DM[（1Yes,0No）（β=0.307,P=0.001）,age（β=0.329,P=0.001）,uric acid（β=0.274,P=0.001）,systolic blood pressure（SBP）（β=0.188,P=0.002）and dialysis duration（β=0.129,P=0.027）.They accounted for 66.3% of the total variance.Conclusion Besides DM,age and SBP,uric acid and dialysis duration are independent determinants of large arterial stiffness as well in CAPD patients.