终末期肾脏病和血液透析患者心脏瓣膜钙化的影响因素分析

Analysis of factors affecting cardiac valve calcification in patients with end-stage renal disease and hemodialysis

目的分析终末期肾脏病和血液透析患者心脏瓣膜钙化的影响因素。方法选择安徽合肥市第三人民医院2016年1月—2018年6月收治的81例终末期肾脏病和血液透析患者,根据有无心脏瓣膜钙化将其分为钙化组(31例)及无钙化组(50例),分析终末期肾脏病和血液透析患者心脏瓣膜钙化影响的单因素,对单因素分析中P<0.05的变量纳入多因素Logistic回归分析。结果单因素分析显示,终末期肾脏病和血液透析钙化组及无钙化组的性别、舒张压、收缩压、脑血管疾病、高血压、左室射血分数、左室扩张、瓣膜关闭不全、血红蛋白、三酰甘油、甲状旁腺素、合并用药、原发病比较差异无统计学意义(P>0.05);终末期肾脏病和血液透析有钙化组及无钙化组年龄、糖尿病、透析龄、左室肥厚、腹主动脉钙化评分(AACS)、白蛋白、血磷、血钙、胆固醇、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C),C反应蛋白(C-reactive protein,CRP)比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、糖尿病、透析龄、左室肥厚、AACS、血磷、血钙、胆固醇、LDL-C、CRP为终末期肾病和血液透析患者发生的危险因素,白蛋白及HDL-C为其保护因素(P<0.05)。结论心脏瓣膜钙化为终末期肾脏病和血液透析患者的严重并发症之一,临床应充分评估此类患者心脏瓣膜钙化的风险,并针对可调控因素进行综合干预。

Objective To analyze the influencing factors of cardiac valve calcification in patients with end-stage renal disease and hemodialysis.Methods 81 cases of patients with end-stage renal disease and hemodialysis who treated from January 2016 to June 2018 in our hospital,according to the presence or absence of cardiac valve calcification,it was divided into 31 cases with calcification group and 50 cases without calcification group,the single factors influencing cardiac valve calcification in patients with end-stage renal disease and hemodialysis were analyzed,and variables P<0.05 in single factor analysis were included in multifactor Logistic regression.Results Univariate analysis showed that gender,diastolic blood pressure,systolic blood pressure,cerebrovascular disease,hypertension,left ventricular ejection fraction,left ventricular dilatation,and valve closure in end-stage renal disease and hemodialysis in calcified and non-calcified groups Incomplete,hemoglobin,triglyceride,combined medication,parathyroid hormone,primary disease between nd-stage renal disease and hemodialysiscal cification group and no calcification group were no difference(P>0.05);the age,diabetes,dialysis age,left ventricular hypertrophy,abdominal aortic calcification score(AACS),albumin,serum phosphorus,serum calcium,cholesterol,LDL-C,HDL-C,and CRP in patients with end-stage renal disease and hemodialysis calcification group and no calcification group were statistically significant difference in(P<0.05).multivariate logistic regression analysis showed that age,diabetes,dialysis age,left ventricular hypertrophy,AACS,serum phosphorus,serum calcium,cholesterol,LDL-C,and CRP were risk factors for end-stage renal disease and hemodialysis patients.Albumin and HDL-C as a protective factor(P<0.05).Conclusion Cardiac valve calcification is one of the serious complications in patients with end-stage renal disease and hemodialysis,clinical assessment of the risk of heart valve calcification in these patients should be fully evaluated,comprehensive interventions were conducted for regulatable factors.