臂踝脉搏波传导速度预测腹膜透析患者心血管事件的价值

发布时间：2018-06-07 23:17

  本文选题：腹膜透析 + 臂踝脉搏波传导速度　； 参考：《肾脏病与透析肾移植杂志》2017年03期

【摘要】：目的:评价臂踝脉搏波传导速度(baPWV)对腹膜透析患者主要不良心血管事件(MACE)的预测价值。方法:研究对象为终末期肾病行腹膜透析(PD)治疗3个月的患者103例,收集患者基础资料、baPWV及各项实验室指标,并对相关指标进行分析。结果:随访期间发生MACE患者为MACE组29例,未发生MACE者(non-MACE组)74例。MACE组患者baPWV、缺血修饰白蛋白(IMA)水平、超敏C反应蛋白(hs CRP)较non-MACE组高,24h尿量、血浆白蛋白、总肌酐清除率(Ccr)、残余肾小球滤过率(r GFR)较non-MACE组低。Logistics分析显示baPWV是重要的心血管事件独立危险因素,OR=1.03(95%CI 1.01,1.11)。baPWV预测腹膜透析患者MACE的曲线下面积(AUC)为0.787(95%CI 0.695,0.862,Z=5.592,P0.05),最佳截值为1 714 cm/s,灵敏度68.97%,特异度84.93%。以最佳截值将患者分为两组,正常baPWV组(baPWV1 714 cm/s,71例),高baPWV组(baPWV≥1 714 cm/s,32例),Kaplan-Meier生存分析显示两组无心血管事件存活率存在统计学差异(P0.000 1),Log-rank检验卡方值为33.07。结论:baPWV是腹膜透析患者发生主要不良心血管事件的良好预测指标。
[Abstract]:Objective: to evaluate the predictive value of brachial malleolus pulse wave velocity (BAPWV) for major adverse cardiovascular events (MACEs) in peritoneal dialysis patients. Methods: 103 patients with end-stage nephropathy were treated with PDD for 3 months. The basic data of the patients were collected and analyzed. Results: during the follow-up period, 29 cases of Mace occurred in Mace group, 74 cases in non-MACE group, 74 cases in Mace group. The level of ischemia modified albumin (IMA) was higher than that in non-MACE group. The urine volume and plasma albumin of hypersensitive C-reactive protein hs were higher than that of non-MACE group. Total creatinine clearance rate and residual glomerular filtration rate r GFR) were lower than those in non-MACE group. Logistics analysis showed that BaPWV was an important independent risk factor for cardiovascular events. BaPWV was an important independent risk factor for cardiovascular events. The area under the curve for predicting Mace in peritoneal dialysis patients was 0.78795 CI 0.6950.862P0.05, and the best value was 1,714. Cm / s, sensitivity 68.97, specificity 84.93. The patients were divided into two groups according to the best cut-off value: 71 cases of normal baPWV with 1714 cm / s of PWV, and 32 cases of high BaPWV with PWV 鈮，

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