维持性血液透析患者心血管疾病患病情况及危险因素分析

发布时间：2018-10-11 20:10

【摘要】：目的了解维持性血液透析(MHD)患者并发心血管疾病(CVD)的患病情况,并分析其发生的相关危险因素。方法选取郑州市7家三级医院血液净化中心于2013年10月至2014年10月行血液透析治疗的终末期肾脏病患者472例。收集所有患者的一般情况和相关的实验室检查结果。根据是否发生心血管事件,将患者分为CVD组和无CVD组。采用t检验、χ2检验比较两组患者上述各项指标的差异有无统计学意义,然后采用二分类Logistic回归分析血液透析患者并发心血管疾病的危险因素。结果472例MHD患者中,平均年龄55.60±11.93岁,男性243例,女性229例,平均透析龄39.30±21.85月。发生心血管事件的患者266例,发病率为56.4%。CVD组与无CVD组比较,年龄、透析龄、透析前收缩压、透析前血肌酐(Scr)、血尿酸(UA)、胱抑素C(Cys-C)、尿素清除指数(Kt/V)、甘油三酯(TG)、超敏C反应蛋白(hs-CRP)、血磷、B型脑钠肽(BNP)的差异有统计学意义(P0.05);性别、体质量指数(BMI)、透析前舒张压、血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血钙、全段甲状旁腺素(iPTH)、透析前尿素氮(BUN)的差异无统计学意义。Logistic回归分析显示,年龄、透析龄、血尿酸、胱抑素C、甘油三酯及超敏C反应蛋白是血液透析患者发生CVD的危险因素。结论1、心血管疾病在MHD患者中的发病率高,需积极预防和治疗;2、年龄、透析龄、血尿酸、胱抑素C、甘油三酯及超敏C反应蛋白可能是MHD患者发生心血管疾病的独立危险因素。
[Abstract]:Objective to investigate the prevalence and risk factors of cardiovascular disease (CVD) in patients with maintenance hemodialysis (MHD). Methods from October 2013 to October 2014, 472 patients with end-stage kidney disease who were treated by hemodialysis in blood purification center of 7 tertiary hospitals in Zhengzhou were selected. Collect general information of all patients and relevant laboratory results. Patients were divided into CVD group and no CVD group according to whether cardiovascular events occurred. T test and 蠂 2 test were used to compare the difference of the above indexes between the two groups. Then the risk factors of cardiovascular disease in hemodialysis patients were analyzed by Logistic regression analysis. Results in 472 patients with MHD, the mean age was 55.60 卤11.93 years, male 243, female 229, mean dialysis age 39.30 卤21.85 months. The incidence of cardiovascular events in 56.4%.CVD group was compared with that in no CVD group, age, systolic blood pressure before dialysis. Before dialysis, there were significant differences in serum creatinine (Scr), (UA), cystatin C (Cys-C), urea clearance index (Kt/V), triglyceride (TG), hypersensitive C-reactive protein (hs-CRP), serum phosphorus and type B brain natriuretic peptide (BNP) (P0.05). Hemoglobin (Hb), total protein (TP), albumin (ALB), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum calcium, total parathyroid hormone (iPTH), before dialysis urea nitrogen (BUN) had no significant difference. Age of hemodialysis, serum uric acid, cystatin C, triglyceride and hypersensitive C-reactive protein were risk factors of CVD in hemodialysis patients. Conclusion (1) the incidence of cardiovascular disease in MHD patients is high and should be actively prevented and treated. 2, age, dialysis age, serum uric acid, cystatin C, triglyceride and hypersensitive C-reactive protein may be independent risk factors for cardiovascular disease in MHD patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5;R54

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