心脏瓣膜钙化对维持性血液透析患者心血管预后的影响

发布时间：2017-12-31 22:14

本文关键词：心脏瓣膜钙化对维持性血液透析患者心血管预后的影响　出处：《南方医科大学学报》2016年07期 　论文类型：期刊论文

【摘要】：目的探讨心脏瓣膜钙化(HVC)对维持性血液透析(MHD)患者心血管预后的影响。方法入组2009~2011年302例MHD患者(其中99例伴HVC),所有患者随访2年,采用生存曲线分析心血管终点事件,Cox回归分析心脏瓣膜钙化对心血管预后的影响。结果患者初始透析的平均年龄为58.2岁,男性占53.6%。随访2年,HVC与非HVC组患者全因死亡、心血管死亡和新发心血管事件发生率分别为30.3%vs 16.3%、22.2%vs 6.9%和48.5%vs 25.6%(P0.05)。生存曲线分析显示两组在全因死亡率(Log Rank P=0.006)、心血管死亡(P0.001)和新发心血管事件(P0.001)方面均存在统计学差异。Cox回归分析显示,校正后HVC仍然显著增加患者全因死亡[HR 1,88,95%CI:(1.11-3.19)]、心血管死亡[3.47(1.76-6.84)]和新发心血事件风险[1.64(1.09-2.47)]。结论 HVC是MHD患者心血管死亡及新发心血管事件的独立危险因素。
[Abstract]:Objective to investigate the effect of valvular calcification on cardiovascular prognosis in patients with maintenance hemodialysis (MHD). Methods from 2009 to 2011, 302 patients with MHD were enrolled. Among them, 99 cases were accompanied with HVC. All patients were followed up for 2 years, and the cardiovascular endpoint events were analyzed by Cox regression analysis. Results the mean age of initial dialysis was 58.2 years. The incidence of cardiovascular death, cardiovascular death and new cardiovascular events were 30.3 vs 16.3%, respectively. 22.2vs 6.9% and 48.5% vs 25.6% P0.05.The survival curve analysis showed that the two groups had a total mortality rate (Log Rank P0. 006). The regression analysis showed that HVC still significantly increased the total mortality after correction in patients with cardiovascular events (P 0.001) and new cardiovascular events (P 0.001). [HR 1 / 88 / 95 CI: 1.11-3.19], Cardiovascular death. [3.47 1.76-6.84)] and risk of New Heart Blood events. [Conclusion HVC is an independent risk factor for cardiovascular death and new cardiovascular events in patients with MHD.
【作者单位】：南方医科大学;广东省人民医院肾内科//广东省医学科学院;
【基金】：国家自然科学基金青年基金(81200544);国家自然科学基金面上项目(81570609) “十二五”国家科技支撑计划项目(2011BAI10B08) 广东省科技计划基金(2015A020210069)~~
【分类号】：R54;R692.5
【正文快照】： 透析患者被视为心血管疾病(cardiovasuclardisease,CVD)的最高危人群[1-2],其CVD死亡率比普通人群高出10~30倍[3-4],占透析患者总体死亡率的一半以上。在众多影响透析患者生存结局及CVD并发症的因素当中,血管或心脏瓣膜钙化(heart valvular calcification,HVC)是影响预后的最

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