C反应蛋白/白蛋白比值与维持性血液透析患者心血管事件风险的关系

The association between C⁃reactive protein/albumin ratio and the risk of cardiovascular events in maintenance hemodialysis patients

目的探讨C反应蛋白/白蛋白比值(C-reactive protein to albumin ratio,CAR)与维持性血液透析(maintenance hemodialysis,MHD)患者出现心血管事件风险的相关性。方法选择2016年8月至2019年12月在广州医科大学附属第二医院血液净化中心进行治疗的MHD患者为研究对象,随访截止时间为2021年3月31日。收集符合研究纳入标准的患者的人口学资料、合并症、原发病因、规律透析治疗3个月后的生化指标及随访截止时间内心血管事件发生情况。采用Kaplan-Meier法估计MHD患者出现心血管事件的概率。基于广义倾向性得分加权(GPSW)的Cox比例风险回归模型评估CAR水平与MHD患者出现心血管事件风险的关联。结果共纳入符合标准的研究对象170例,其中64例患者出现心血管事件(占37.6%)。基于GPSW的Cox比例风险回归模型提示(HR_(CAR)=2.087,95%CI:1.085~4.015,P=0.028),说明MHD患者的CAR平均每增加一个单位,出现心血管事件的风险比为2.087。结论CAR与MHD患者的心血管事件风险存在显著的正相关关系,这将有助于临床工作者识别具有高心血管事件风险的MHD患者并及时干预。

Objective To explore the association between C-reactive protein/albumin ratio(CAR)and the risk of cardiovascular events in maintenance hemodialysis(MHD)patients.Methods This study enrolled MHD patients who were treated in the blood purification center of the Second Affiliated Hospital of Guangzhou Medical University between August 2016 to December 2019,and the follow-up deadline was March 31,2021.Collected the clinical data of patients who conform to the inclusion criteria,including demographic,complications,primary basic disease,biochemical indicators of the patients who underwent 3 months regular dialysis treatment and the occurrence of cardiovascular events during the follow-up period.The Kaplan-Meier method was used to estimate the probability of cardiovascular incidents in MHD patients.The Cox proportional hazards model based on generalized propensity score weighting(GPSW)was used to estimate the relationship between CAR and cardiovas⁃cular events in MHD patients.Results A total of 170 eligible objects were included in this study,64 patients with cardiovascular events(37.6%).The Cox proportional hazards model which based on GPSW(HR_(CAR)=2.087,95%CI:1.085~4.015,P=0.028),indicated that the hazard ratio of cardiovascular events was 2.087 when the CAR each additional a unit in MHD patients.Conclusion CAR and the risk of cardiovascular events in MHD patients have a significant positive correlation,which can help clinical workers recognize the MHD patients who have high risk of cardiovascular events and intervene in time.