维持性血液透析患者冠状动脉钙化评价及其危险因素分析

The evaluation and risk factors analysis of coronary calcification in maintenance hemodialysis patients

目的评价血液透析患者冠状动脉钙化程度以及对其危险因素进行分析。方法收集我院2003年1月至2010年1月间血液透析患者并行冠脉CT检查者，将人选40例分为冠脉钙化组（26例）与非冠脉钙化组（14例），对血生化和血管钙化等危险因素进行比较。结果在冠脉钙化组的血磷、钙磷乘积、唧、CRP、LDL和CHOL均显著高于非冠脉钙化组（P〈0．05），年龄和血液透析时间均显著大于非冠脉钙化组，血钙在两组并没有显著的差异，而具有糖尿病史、吸烟史和肥胖方面的比例均高于非冠脉钙化组，选择进行了低钙透析的比例却明显低于非冠脉钙化组。结论继发性甲状旁腺素功能亢进是血液透析患者冠脉钙化的重要原因，血液透析时间、年龄、糖尿病、吸烟和肥胖是其高危因素，低钙透析液可以降低冠脉钙化的发生。

Objective To evaluate and analyze risk factors of coronary calcification in maintenance he- modialysis patients. Methods 40 maintenance hemodialysis patients with coronary artery CT examination from Jan 2003 to Jan 2010 were divided into coronary calcification group （N = 26 ）and non-coronary calcification group（ N = 14）. Serum chemical substance and risk factors were compared between two groups. Results The calcium, phosphate, parathyroid hormone, C reactive protein, LDL and CHOL increased in coronary calcification group （ P 〈 0.05 ）. Conclusion Hyperparathyroidism might be a major reason for coronary calcification in main- tenanee hemodialysis patients. Hemodialysis duration, age, smoking history, diabetes, and obesity are risk factors, and low-calcium dialysate attenuated coronary calcification.