iPTH、AKP联合FER检测在MHD不良心血管事件预测中的应用

Application of iPTH,AKP combined with FER detection in the prediction of adverse cardiovascular events in MHD

目的研究全段甲状旁腺激素(iPTH)、碱性磷酸酶(AKP)联合铁蛋白(FER)检测在维持性血液透析(MHD)不良心血管事件预测中的应用。方法收集2019年8月至2020年12月于重庆市大足区人民医院进行维持性血液透析治疗的134例患者设为研究组,根据患者有无不良心血管事件的发生分为发生组和未发生组;另选取87名同时间段健康体检者作为健康组。比较两组、发生以及未发生不良心血管事件患者iPTH、AKP、FER水平,统计不良心血管事件发生率及相关影响危险因素,同时分析iPTH、AKP、FER及三者联合检测对不良心血管事件发生的预测价值。结果研究组iPTH、AKP、FER水平高于健康组,差异均有统计学意义(P<0.05)。发生不良心血管事件者43例(32.09%),未发生不良心血管事件者91例(67.91%)。发生组iPTH、AKP、FER水平高于未发生组,差异均有统计学意义(P<0.05)。iPTH、AKP、FER为影响不良心血管事件发生的因素(P<0.05)。ROC曲线显示:iPTH、AKP、FER单独检测及三者联合检测AUC分别为0.812、0.836、0.809、0.913,其中以三者联合检测AUC值最大(P<0.05)。结论iPTH、AKP、FER联合检测有利于临床预测不良心血管事件发生,其对维持性血液透析患者预后具有重大的意义。

Objective To study the application of intact parathyroid hormone(iPTH),alkaline phosphatase(AKP),and ferritin(FER)detection in predicting adverse cardiovascular events in elderly patients undergoing maintenance hemodialysis.Methods A total of 134 patients who underwent maintenance hemodialysis in Dazu District People’s Hospital of Chongqing from August 2019 to December 2020 were collected as the research group,and they were divided into the occurrence group and the non-occurrence group according to whether the patients had adverse cardiovascular events;Another 87 healthy subjects during the same time period were selected as the healthy group.The levels of iPTH,AKP and FER in the two groups,patients with and without adverse cardiovascular events were compared.The operating characteristic curve(ROC)was used to analyze the predictive value of iPTH,AKP,FER and the combined detection of iPTH,AKP and FER for adverse cardiovascular events.Results The levels of iPTH,AKP and FER in the study group were higher than those in the healthy group,the difference is statistically significant(P<0.05).Adverse cardiovascular events occurred in 43 cases(32.09%)and 91 cases(67.91%)without adverse cardiovascular events.The levels of iPTH,AKP and FER in the occurrence group were higher than those in the non-occurrence group,the difference is statistically significant(P<0.05).iPTH,AKP and FER were independent risk factors for adverse cardiovascular events(P<0.05).The ROC curve showed that the AUCs of i PTH,AKP,FER alone and the combined detection of the three were 0.812,0.836,0.809,and 0.913,respectively,and the combined detection of the three had the highest AUC value(P<0.05).Conclusion The combined detection of i PTH,AKP and FER is beneficial to the clinical prediction of adverse cardiovascular events,which is of great significance for the prognosis of patients with maintenance hemodialysis.