MHR、血尿酸与维持性血液透析患者预后的关系

Relationship between MHR,Serum Uric Acid and Prognosis of Maintenance Hemodialysis Patients

目的探讨单核细胞/高密度脂蛋白比值(MHR)、血尿酸(SUA)对维持性血液透析(MHD)患者预后的评估价值。方法回顾性分析2017年1月1日~2020年6月30日合肥市第一人民医院血液透析中心规律透析3个月以上共215例患者的临床资料,根据临床结局是否死亡分为死亡组和生存组。比较两组间的临床指标,并计算得出MHR,采用Logistic回归分析法分析MHR以及SUA预测MHD患者全因死亡的价值。结果215例患者中有57例死亡,占26.5%。与死亡组比较,患者MHR水平更高,而SUA、血红蛋白、白蛋白、肌酐、血磷水平更低,差异均有统计学意义(P<0.05);多因素Logistic回归分析提示MHR、SUA是MHD患者全因死亡的独立危险因素,差异均有统计学意义(P<0.05)。ROC曲线提示MHR≥0.46、SUA≤345.45μmol/L时,MHD死亡风险增加。结论MHR、SUA可独立于其他因素预测MHD患者全因死亡的风险,过高的MHR以及低SUA提示血液透析患者的生存预后较差。

Objective To evaluate the prognostic value of mononuclear cell high-density lipoprotein ratio(MHR)and serum uric acid(SUA)in maintenance hemodialysis(MHD)patients.Methods The clinical data of 215 patients with regular dialysis in the hemodialysis center of Hefei First People′s hospital from January 1,2017 to June 30,2020 were retrospectively analyzed.The patients were followed up until June 30,2017.The patients were treated with regular dialysis for more than 3 months.The patients were divided into death group and survival group according to clinical outcome.MHR was calculated and MHR was compared between the two groups.MHR and SUA were analyzed by logistic regression to predict all-cause death.Results Among the 215 patients,57(26.5%)died.Compared with the death group,the level of MHR was higher,but the levels of SUA,hemoglobin,albumin,creatinine and serum phosphorus were lower(P<0.05).Multiple logistic regression analysis indicated that MHR and SUA were independent risk factors for all-cause mortality in MHD patients,and the differences were statistically significant(P<0.05).The ROC curve indicated that MHD death risk increased when MHR≥0.46 and SUA≤345.45μmol/L.Conclusion MHR and SUA can independently predict the risk of all-cause death in MHD patients.High MHR and low SUA suggest poor survival in hemodialysis patients.