腹膜透析患者发生心血管钙化的影响因素

Influencing factors of cardiovascular calcification in peritoneal dialysis patients

目的探讨影响腹膜透析患者发生心血管钙化的相关危险因素。方法收集50例接受腹膜透析治疗患者的临床资料(主要为可能导致心血管钙化的资料),包括年龄、性别、体质量指数(BMI)、体表面积(BSA)、血压、原发疾病、透析龄,血清钙、磷,糖、脂代谢水平,肾功能指标等,根据患者是否发生心血管钙化分为钙化组和非钙化组,比较两组患者以上的资料是否有差异,再将有组间差异的指标用Logistic回归分析筛选出可以用于预测腹膜透析患者发生心血管钙化的高危因素和保护因素。结果经评估,钙化组28例患者,非钙化组22例患者。经Logistic回归分析,年龄、透析龄、血清磷、残余肾功能与心血管钙化相关。结论高龄、高透析龄、高血清磷、低残余肾功能均是腹膜透析患者发生心血管钙化的重要危险因素。因此,临床上对于高龄、长期行腹膜透析治疗的患者应高度重视其钙磷平衡,及时采取干预措施保护患者的残余肾功能,以降低其心血管钙化的发生,同时预防心血管疾病的发生。

Objective To investigate the relevant factors affecting cardiovascular calcification in patients with peritoneal dialysis. Methods The data of 50 patients who received peritoneal dialysis may lead to cardiovascular calcification, including age, gender, body mass index, body surface area, blood pressure, primary disease, dialysis age, serum calcium, phosphorus, blood glucose, lipid metabolism, renal function indexes were collected. According to whether with cardiovascular calcification, the patients were divided into calcification group and non calcification group. And then the data of the two group were compared, the differences of the indexes between the groups were analyzed by Logistic regression analysis that can filtrate risk factors and protective factors for predicting the risk of cardiovascular calcification in patients with peritoneal dialysis. Results There were 28 patients in the calcification group and 22 patients in non calcification group. The Logistic regression analysis showed that age, dialysis age, serum phosphorus, residual renal function associated with cardiovascular calcification （P 〈 0. 05）. Conclusion Advanced age, high dialysis age, high serum phosphorus, low residual renal function are important risk factors for cardiovascular calcification in peritoneal dialysis patients. Therefore, it is important to pay attention to the balance of calcium and phosphorus, to take timely intervention measures to protect the residual renal function, in order to reduce the occurrence of cardiovascular calcification in elderly and long-term peritoneal dialysis patients.