超敏肌钙蛋白对维持性血液透析患者的短期预后作用

发布时间：2018-03-02 02:22

  本文关键词： 超敏肌钙蛋白 维持性血液透析 危险分级 预后评估　出处：《复旦学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨超敏肌钙蛋白(high-sensitivity cardiac troponin T,hs-cTnT)对维持性血液透析(maintainance hemodialysis,MHD)患者的短期预后作用。方法入组296例MHD患者,回顾性分析其临床资料,患者血液透析前采集血清检测hs-cTnT和相关心血管风险标志物。随访时间总长为13个月,记录主要终点事件(全因死亡)及发生时间;用t检验、Mann-Whitney U检验和χ2检验分析比较全因死亡与生存组风险标志物之间的差异,使用X-tile计算出hs-cTnT的最佳二分位切点,绘制Kaplan-Meier生存曲线,用Logistic回归分析高危及非高危hs-cTnT之间的死亡风险比。根据hs-cTnT健康人群第99百分位点将非高危组细分为中危组和低危组来进一步评估其对MHD患者短期预后的影响。结果 MHD患者生存与全因死亡组的血清hs-cTnT水平分别为0.05(0.03~0.07)ng/mL和0.07(0.04~0.14)ng/mL(P=0.027);hs-cTnT的最佳二分位切点为0.1 ng/mL;高危组(hs-cTnT0.1 ng/mL)患者生存率(76.67%)显著低于非高危组(hs-cTnT≤0.1 ng/mL)患者生存率(96.62%)(P0.05);高危组患者死亡风险较非高危组患者高7.288倍(P0.001);在非高危人群组中,中危组(hs-cTnT0.014 ng/mL)患者生存率低于低危组(hs-cTnT≤0.014 ng/mL)患者生存率,低危组在随访期间无死亡事件发生。结论 hs-cTnT是MHD患者死亡的独立危险因素,并可作为MHD患者短期的死亡风险分级和预后评估的有力指标。
[Abstract]:Objective to investigate the short-term prognostic effect of high-sensitivity cardiac troponin TnT on maintainance hemodialysis (MHD) patients. Methods 296 patients with MHD were enrolled and their clinical data were analyzed retrospectively. Serum samples were collected before hemodialysis to detect hs-cTnT and related cardiovascular risk markers. The total follow-up time was 13 months. The main end point events (all causes of death) and the time of occurrence were recorded. T test Mann-Whitney U test and 蠂 2 test were used to compare the difference between the risk markers of all-cause death and survival group. X-tile was used to calculate the best binary tangent point of hs-cTnT and draw the survival curve of Kaplan-Meier. The mortality risk ratio between high and non-high risk hs-cTnT was analyzed by Logistic regression analysis. According to the 99th percentile of hs-cTnT healthy population, the non high risk group was subdivided into middle risk group and low risk group to further evaluate its impact on the short-term prognosis of MHD patients. The serum hs-cTnT levels of patients with MHD were 0.05ng / mL and 0.07ng / mL, respectively, and 0.07ng / mL and 0.07ng / g / mL of 0.07ng / mL and 0.07ng / 0.04 / 0.14ng / ml respectively. The optimal binary-point of 0.027ng- cTnT was 0.1 ng / mL; the survival rate of patients with high risk group was 76.67); the survival rate of patients with Hs-cTnTnT 鈮，

本文编号：1554626