C反应蛋白/清蛋白对维持性血液透析患者死亡的预测价值研究

Value of CRP/ALB Ratio in Predicting Mortality in Maintenance Hemodialysis Patients

目的探讨C反应蛋白/清蛋白(CRP/ALB)对维持性血液透析(MHD)患者死亡的预测价值。方法采用前瞻性队列研究方法,收集2006年12月—2007年1月在我院行规律血液透析的患者53例,随访至2012年1月,记录患者死亡时间和死亡原因,应用Cox回归模型分析CRP/ALB对死亡的预测价值,采用受试者工作特征曲线(ROC曲线)比较CRP/ALB与单用CRP或ALB预测死亡效果的差别。结果在60个月的随访中,共有26例(49%)患者死亡。Cox回归分析显示高CRP/ALB、低ALB和高CRP是MHD患者死亡的独立危险因素(HR值分别为3.150、3.107和5.717),ROC曲线下面积分别为0.769(CRP/ALB)、0.757(ALB)和0.749(CRP),但3者之间差异均无统计学意义(P>0.05)。结论高CRP/ALB比值是独立预测MHD患者死亡的危险因素。

Objective To evaluate the value of CRP/ALB ratio in predicting mortality in maintenance hemodialysis（MHD） patients.Methods Fifty-three patients undergone MHD in our hospital between December 2006 and January 2007 were included in this prospective study and followed up until January 2012.Time and cause of death were recorded.Cox regression model was used to analyze the value of CRP / ALB ratio in predicting death.The ROC curves were drawn up to assess the ability of these markers（CRP / ALB ratio,CRP,and ALB） in mortality prediction.Results Totally 26（49%） patients died during the 60 months＇ follow-up.Cox regression analysis showed that high CRP / ALB ratio,high CRP,and low ALB were independent risk factors for mortality of MHD patients（HR = 3.150,3.107,5.717）.The areas under ROC curves for these markers were 0.769（CRP / ALB ratio）,0.757（ALB）,and 0.749（CRP）,but there was no significant difference among them.Conclusion High CRP / ALB ratio is an independent predictor of mortality in MHD patients.