维持性血液透析合并冠心病患者冠状动脉病变程度的影响因素研究

Influencing Factors of the Extent of Coronary Artery Disease in Maintenance Hemodialysis Patients with Coronary Heart Disease

目的探讨维持性血液透析(MHD)合并冠心病(CHD)患者冠状动脉病变程度的影响因素。方法选取2017年1月至2022年8月北部战区总医院收治的MHD合并CHD患者81例。收集患者的基本资料。根据冠状动脉造影检查结果,采用Gensini积分评估冠状动脉病变程度。采用Spearman秩相关分析探讨计量资料与Gensini积分的相关性。采用多重线性回归分析探讨MHD合并CHD患者Gensini积分的影响因素。结果MHD合并CHD患者的透析龄(r_(s)=0.228)、超敏C反应蛋白(hs-CRP)(r_(s)=0.264)、血清磷(r_(s)=0.264)、纤维蛋白原(FIB)(r_(s)=0.349)、超敏心肌肌钙蛋白T(hs-cTnT)(r_(s)=0.275)与Gensini积分呈正相关(P<0.05)。多重线性回归分析结果显示,血清钙、FIB、hs-cTnT是MHD合并CHD患者Gensini积分的影响因素(P<0.05)。结论血清钙、FIB、hs-cTnT是MHD合并CHD患者冠状动脉病变程度的影响因素。临床医生可动态监测上述指标水平变化,以评估患者冠状动脉病变程度,进而尽早施行必要的检查及干预措施,改善患者预后。

Objective To investigate the influencing factor_(s) of the extent of coronary artery disease(CHD)in maintenance hemodialysis(MHD)patients with coronary heart disease.Methods A total of 81 MHD patients with CHD admitted in the General Hospital of Northern Theater Command from January 2017 to August 2022 were selected.Basic data of patients were collected.According to the results of coronary angiography,Gensini score was used to evaluate the extent of coronary artery disease.Spearman rank correlation analysis was used to explore the correlation between measurement data and Gensini score.Multiple linear regression analysis was used to investigate the influencing factor_(s) of Gensini score in MHD patients with CHD.Results Dialysis age(r_(s)=0.228),hyper_(s)ensitive C-reactive protein(hs-CRP)(r_(s)=0.264),serum phosphorus(r_(s)=0.264),fibrinogen(FIB)(r_(s)=0.349),hyper_(s)ensitive cardiac troponin T(hs-cTnT)(r_(s)=0.275)were positively correlated with Gensini scores in MHD patients with CHD(P<0.05).Multiple linear regression analysis showed that serum calcium,FIB,and hs-cTnT were influencing factor_(s) of Gensini score in MHD patients with CHD.Conclusion Serum Ca,FIB,and hs-cTnT are influencing factor_(s) of the extent of coronary artery disease in MHD patients with CHD.In clinical practice,changes of their levels can be dynamically monitored to evaluate the extent of coronary artery disease of patients,and necessary examination and intervention measures can be implemented as soon as possible to improve the prognosis of patients.