维持性血液透析患者心脏瓣膜钙化的相关风险因素及其对远期预后的影响

Risk factors associated with cardiac valve calcification in maintenance hemodialysis patients and its effect on long-term prognosis

目的探讨维持性血液透析患者心脏瓣膜钙化(CVC)的相关风险因素及其对远期预后的影响。方法回顾性分析2016年1月1日至2018年1月1日在该院行超声心动图检查的维持性血液透析患者157例作为研究对象。研究对象根据心脏超声检查结果分为非CVC组101例和CVC组56例,比较两组患者临床资料。采用多因素Logistic回归模型分析维持性血液透析患者CVC的风险因素。采用Kaplan-Meier生存曲线及Cox回归模型分析维持性血液透析患者CVC与全因死亡之间的关系。结果CVC组糖尿病史占比、甘油三酯、血清校正钙、血清磷、C反应蛋白(CRP)水平均高于非CVC组,血清白蛋白水平低于非CVC组,差异有统计学意义(P<0.05)。CRP、糖尿病史、血清白蛋白<35 g/L、血清校正钙>2.35 mmol/L及高血清磷是维持性血液透析患者CVC的独立风险因素(P<0.05)。CVC、年龄、血清白蛋白<35 g/L、高血清磷是维持性血液透析患者全因死亡的独立风险因素(P<0.05)。结论CRP、糖尿病史、血清白蛋白<35 g/L、血清校正钙及高血清磷与维持性血液透析患者CVC发生密切相关,CVC、年龄、血清白蛋白<35 g/L、高血清磷与维持性血液透析患者的远期全因死亡相关。

Objective To explore the risk factors associated with cardiac valve calcification(CVC)in maintenance hemodialysis patients and its effect on long-term prognosis.Methods A total of 157 patients with maintenance hemodialysis who underwent echocardiography in the hospital from January 1,2016 to January 1,2018 were retrospectively analyzed.The subjects were divided into 101 cases in non-CVC group and 56 cases in CVC group according to the results of cardiac ultrasound examination,and the clinical data were compared between the two groups.Multivariate Logistic regression model was used to analyze the risk factors of CVC in maintenance hemodialysis patients.Kaplan-Meier survival curve and Cox regression model were used to analyze the relationship between CVC and all-cause death in maintenance hemodialysis patients.Results The diabetes history ratio,triglyceride,serum corrected calcium,serum phosphorus and C-reactive protein(CRP)levels in CVC group were higher than those in non-CVC group,and the serum albumin level was lower than that in non-CVC group,with statistical significance(P<0.05).CRP,diabetes history,serum albumin<35 g/L,serum corrected calcium>2.35 mmol/L and high serum phosphorus were independent risk factors for CVC in maintenance hemodialysis patients(P<0.05).CVC,age,serum albumin<35 g/L and high serum phosphorus were independent risk factors for all-cause death in maintenance hemodialysis patients(P<0.05).Conclusion CRP,diabetes history,serum albumin<35 g/L,serum corrected calcium and high serum phosphorus are closely related to the occurrence of CVC in maintenance hemodialysis patients,and CVC,age,serum albumin<35 g/L and high serum phosphorus are correlated with long-term all-cause death in maintenance hemodialysis patients.