老年慢性肾脏病患者并发肾心综合征的危险因素

Risk factors of renal-cardiac syndrome in elderly patients with chronic kidney disease

目的：探讨老年慢性肾脏病（CKD）并发肾心综合征（RCS）的危险因素，为预防RCS提供参考。方法对2010年3月至2013年3月在解放军总医院住院治疗的222例老年CKD患者的临床资料进行回顾性分析。应用logistic回归分析筛选RCS发生的危险因素。结果老年慢性RCS的发生率为25.2%；单因素分析结果显示，年龄、肾功能分期、糖尿病史、高血压病史、贫血、营养不良与RCS发生有关，而性别、吸烟史、脑血管病史、CKD病程、血脂紊乱等因素与RCS发生无明显相关性（P＞0.05）；多因素logistic回归法分析表明，年龄、肾功能分期、糖尿病、高血压病史、贫血是RCS发生的独立危险因素。结论高龄（≥80岁）、肾功能3B期以上，伴有糖尿病、高血压病史和贫血的CKD患者发生RCS的风险大，应该特别重视对以上危险因素的评估和控制。

Objective To investigate the related risk factors of renal-cardiac syndrome （RCS） in the elderly patients with chronic kidney disease （CKD） in order to provide preventive strategies for RCS. Methods Clinical data of 222 elderly patients with CKD admitted in Chinese PLA General Hospital from March 2010 to March 2013 were collected and retrospectively analyzed. Logistic regression analysis was used to study the related risk factors of RCS. Results The incidence of RCS was 25.2% in this cohort. Univariate analysis showed that age, renal function stage, history of diabetes, hypertension, anemia, and malnutrition were related with the occurrence of RCS, while sex, smoking, history of cerebrovascular disease, duration of CKD, dyslipidemia and other factors had no obvious correlation with RCS （P〉0.05）. Multivariate logistic regression analysis showed that, age, renal function stage, diabetes, hypertension, and anemia were independent risk factors for RCS. Conclusion CKD patients with advanced age （≥80 years）, advanced renal dysfunction （≥stage 3B）, diabetes, hypertension and anemia are of high risk of RCS. Therefore, special attention should be paid to the evaluation and control of above-mentioned risk factors.