维持性透析患者血清糖类抗原125水平及左房内径相关因素分析

Relationship between serum carbohydrate antigen 125 level and left atrial diameter in patients undergoing maintenance dialysis

目的探讨维持性透析患者血清糖类抗原125(CA125)水平及左房内径的相关因素分析。方法选取自2015年1月至2015年12月行维持性透析治疗并行血清CA125及心脏超声检测的100例患者为研究对象。分析CA125、左房内径与年龄、透析龄、胸腔积液、血压、B型脑钠肽及各生化指标的相关性。采用Logistic回归分析CA125水平升高和左房内径增大的危险因素。结果患者按照血清CA125水平分成CA125正常组(n=80)与CA125升高组(n=20)。与CA125正常组比较,CA125升高组存在胸腔积液患者较多,肌钙蛋白I、B型脑钠肽水平较高,左房内径较大,差异均有统计学意义(P<0.05)。患者按照左房内径分成左房内径正常组(n=42)与左房内径增大组(n=58)。与左房内径正常组比较,左房内径增大组存在胸腔积液的患者较多,收缩压、肌钙蛋白I、B型脑钠肽及CA125水平较高,血红蛋白、甘油三脂与总胆固醇水平较低,差异均有统计学意义(P<0.05)。血清CA-125水平与收缩压、总胆固醇、低密度脂蛋白、肌钙蛋白I、B型脑钠肽、胸腔积液呈正相关,与血清肌酐水平呈负相关(P<0.05)。左房内径与收缩压、肌钙蛋白I、B型脑钠肽、胸腔积液呈正相关,与血红蛋白水平、甘油三酯呈负相关(P<0.05)。血清CA125水平与左房内径间呈正相关(P<0.05)。Logistic回归分析结果显示,B型脑钠肽分级(OR=3.259,95%可信区间1.383~7.678)与胸腔积液(OR=12.466,95%可信区间3.340~46.528)是维持性透析患者血清CA125水平升高的独立危险因素(P<0.01);收缩压(OR=1.026,95%可信区间1.005~1.048)与B型脑钠肽分级(OR=2.849,95%可信区间1.639~4.951)是引起左房内径增大的独立危险因素(P<0.01)。结论维持性透析患者血清CA125水平与左房内径呈显著正相关,但二者之间相关性并不是独立直接的相关关系。

Objective To investigate the relationship between serum carbohydrate antigen 125（ CA125） level and left atrial diameter（ LAD） in patients undergoing maintenance dialysis. Methods A retrospective study was performed on 100 cases of patients undergoing maintenance dialysis and cardiac ultrasound from January to December 2015. The relationship between CA125 and LAD in age,dialysis ages,pleural effusion,blood pressure and B-type brain natriuretic peptide（ BNP） was analyzed. Risk factors of increased CA125 level and dilated LAD were analyzed by binary Logistic regression. Results According to the serum CA125 level,patients were divided into the normal CA125 group（ n = 80） and the elevated CA125 group（ n = 20）. Compared with the patients in the normal CA125 group,patients in the elevated CA125 group had more pleural effusion,higher levels of troponin I and B-type BNP and larger LAD,and the difference was statistical significant（ P〈 0. 05）. According to the different LAD,patients were divided into the normal LAD group（ n = 42） and the dilated LAD group（ n = 58）. Compared with the normal LAD group,patients of the dilated LAD group had more pleural effusion,higher levels of systolic pressure,troponin I,B-type BNP and CA125,lower levels of hemoglobin,triglycerides and total cholesterol（ P〈 0. 05）. Serum CA125 level was positively correlated with systolic pressure,total cholesterol,LDL,troponin I,B-type BNP and pleural effusion,while it was negatively correlated with serum creatinine level（ P〈 0. 05）. LAD was positively correlated with systolic pressure,troponin I,B-type BNP and pleural effusion,and negatively correlated with hemoglobin level and triglycerides（ P 0. 05）. Serum CA125 level was positively correlated with LAD（ P〈 0. 05）. Logistic regression analysis showed that B-type BNP grading（ OR = 3. 259,95% CI： 1. 383-7. 678） and pleural effusion（ OR = 12. 466,95% CI： 3. 340-46. 528） were independent risk factors for serum CA125 elevated level（ P〈 0. 01）; systolic pressure（ OR = 1. 026,95% CI： 1. 005-1. 048） and B-type BNP grading（ OR =2. 849,95% CI： 1. 639-4. 951） were independent risk factors for dilated LAD（ P〈 0. 01）. Conclusion Serum CA125 level is positively correlated with left atrial diameter in patients undergoing maintenance dialysis,while the correlation between them is not independent and direct.