慢性肾功能衰竭患者并发心血管疾病的危险因素及与蛋白质能量消耗状态的相关性

Risk factors of cardiovascular disease in patients with chronic renal failure and their relationship with protein and energy consumption

目的分析慢性肾功能衰竭患者并发心血管疾病的危险因素及与蛋白质能量消耗(PEW)状态的相关性。方法选择2018年1月—2019年1月新疆医科大学第一附属医院肾脏疾病中心血液透析一科收治的慢性肾功能衰竭患者220例作为研究对象,根据患者预后是否并发心血管疾病为心血管并发症组(n=96)和无心血管并发症组(n=124)。比较2组患者临床资料差异,并采用基于多频生物电阻抗技术对患者PEW状态指标进行测定。采用多因素Logistic回归法对慢性肾功能衰竭患者并发心血管疾病的危险因素进行分析;并采用Pearson法对其与慢性肾功能衰竭患者并发心血管疾病的相关性进行分析。结果与无心血管并发症组比较,心血管并发症组患者血清cTnT、Hcy、CRP、TG、HDL-C、血糖、体脂比例、OH≥2L/OH<2L及PEW发生率明显升高,LDL-C水平、瘦体质量、肌肉质量、体脂质量明显降低(t/χ^2=22.817、25.880、48.518、43.049、50.728、117.780、11.827、13.468、39.106、18.199、4.108、6.724、7.436,P均<0.001)。经多因素Logistic回归分析显示,cTnT、Hcy、CRP、TG、HDL-C、LDL-C及PEW发生率是慢性肾功能衰竭患者并发心血管疾病的独立危险因素。经Pearson相关性分析显示,慢性肾功能衰竭患者并发心血管疾病与瘦体质量、肌肉质量、体脂重量呈负相关,与体脂比例及OH≥2L/OH<2L水平呈正相关(r/P=-0.653/<0.001、-0.756/<0.001、-0.569/<0.001,0.698/<0.001、0.383/0.012)。结论cTnT、Hcy、CRP、TG、HDL-C、LDL-C及PEW发生率是慢性肾功能衰竭患者并发心血管疾病的危险因素,且与PEW相关指标呈现一定相关性。

Objective To analyze the risk factors of cardiovascular disease in patients with chronic renal failure and the relationship between the risk factors and the state of protein energy consumption(PEW).Methods From January 2018 to January 2019,220 patients with chronic renal failure were selected as the study objects.According to the prognosis of patients with cardiovascular disease,cardiovascular complications group(n=96)and non-cardiovascular complications group(n=124).The difference of clinical data between the two groups was compared,and the Pew status index was measured based on the multi frequency bioelectrical impedance technology.Multivariate logistic regression was used to analyze the risk factors of cardiovascular disease in patients with chronic renal failure,and Pearson method was used to analyze the correlation between cardiovascular disease in patients with chronic renal failure.Results Compared with the group without cardiovascular complications,the incidence of Serum cTnT,Hcy,CRP,TG,HDL-C,blood glucose,body fat ratio,OH≥2L/OH<2L and pew in the cardiovascular complications group was significantly higher,and LDL-C was significantly higher C level,lean body mass,muscle mass and body fat mass decreased significantly(t/χ^2=22.817,25.880,48.518,43.049,50.728,117.780,11.827,13.468,39.106,18.199,4.108,6.724,7.436,P<0.001).Multiple logistic regression analysis showed that the incidence of cTnT,Hcy,CRP,TG,HDL-C,LDL-C and Pew were independent risk factors of cardiovascular disease in patients with chronic renal failure.Pearson correlation analysis showed that cardiovascular disease in patients with chronic renal failure was negatively correlated with lean body mass,muscle mass and body fat weight,and positively correlated with body fat ratio and OH≥2L/OH<2L level(r/P=-0.653/<0.001,-0.756/<0.001,-0.569/<0.001,0.698/<0.001,0.383/0.012).Conclusion The incidence of cTnT,Hcy,CRP,TG,HDL-C,LDL-C and PEW are risk factors of cardiovascular disease in patients with chronic renal failure,and they are related to PEW.