慢性肾衰竭血液透析患者血小板分布宽度、白蛋白水平对腹主动脉钙化发生的影响

Effect of platelet distribution width and albumin level on abdominal aortic calcification in hemodialysis patients with chronic renal failure

目的:探究慢性肾衰竭(Chronic renal failure,CRF)血液透析患者血小板分布宽度(Platelet distribution width,PDW)、白蛋白(Albumin,ALB)水平对腹主动脉钙化发生的影响。方法:纳入2020年1月至2021年10月我院130例CRF行血液透析患者,于透析治疗前检查患者PDW、血清ALB水平。透析治疗后开展12 m随访,记录所有患者透析治疗后腹主动脉钙化发生情况。分析PDW、血清ALB水平对血液透析患者并发腹主动脉钙化的影响。结果:共完成127例随访工作,其中发生腹主动脉钙化41例,占比32.28%。发生组治疗前PDW水平高于未发生组,血清ALB水平低于未发生组(P<0.05)。发生组高血压、肥胖例数占比高于未发生组(P<0.05)。经Logistic回归分析结果显示,治疗前高水平PDW、高血压、肥胖是CRF行血液透析患者发生腹主动脉钙化的危险因素(OR>1,P<0.05),治疗前高水平血清ALB是其保护因素(OR<1,P<0.05)。绘制受试者工作特征曲线,结果显示,PDW、血清ALB及联合预测CRF行血液透析患者发生腹主动脉钙化的曲线下面积均≥0.07,其中联合预测价值最高。结论:PDW水平高、血清ALB水平低是CRF行血液透析患者发生腹主动脉钙化的影响因素,联合检测二者水平可预测评估患者腹主动脉钙化发生风险。

Objective:To investigate the effects of platelet distribution width(PDW)and albumin(ALB)levels on abdominal aortic calcification in hemodialysis patients with chronic renal failure(CRF).Methods:From January 2020 to October 2021,130 CRF hemodialysis patients in our hospital were included.Their PDW and serum ALB levels were examined before dialysis treatment.A 12-month follow-up was carried out after dialysis treatment to record the occurrence of abdominal aortic calcification in all patients after dialysis treatment.The effects of PDW and serum ALB levels on abdominal aortic calcification in hemodialysis patients were analyzed.Results:A total of 127 cases of follow-up were completed,41 cases occurred abdominal aortic calcification,accounting for 32.28%.The PDW level before treatment in the occurrence group was higher than that in the non-occurrence group,and the serum ALB level was lower than that in the non-occurrence group(P<0.05).The proportions of hypertension and obesity in the occurrence group were higher than those in the non-occurrence group(P<0.05).Logistic regression analysis showed that high levels of PDW before treatment,hypertension and obesity were risk factors(OR>1,P<0.05),and high level of serum ALB before treatment was a protective factor for abdominal aortic calcification in CRF hemodialysis patients(OR<1,P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve of PDW,serum ALB and combined prediction of abdominal aortic calcification in hemodialysis patients with CRF was≥0.07,and the combined prediction value was the highest.Conclusion:High level of PDW and low level of serum ALB are the influencing factors of abdominal aortic calcification in CRF patients undergoing hemodialysis.The combined detection of PDW and ALB can predict and evaluate the risk of abdominal aortic calcification.