慢性肾脏病患者血镁与心血管事件相关性分析

发布时间：2018-05-15 03:32

本文选题：慢性肾脏病 + 血镁　；参考：《安徽医科大学学报》2017年02期

【摘要】：目的了解慢性肾脏病(CKD)患者血镁变化及其影响因素,探讨与心血管事件的相关性。方法选取381例CKD 3~5期患者,包括住院患者293例,门诊维持性血液透析(MHD)患者88例。根据血镁水平分为低血镁组、非低血镁组,心脏彩超评估心脏瓣膜有无钙化。对患者进行3~21个月,中位数13个月的随访,记录有无心血管事件发生。结果381例CKD患者中,CKD 3~4期50例,CKD 5期331例。低镁血症121例(31.76%),血镁正常245例(64.30%),高镁血症15例(3.94%)。248例患者行心脏彩超检查,心脏瓣膜钙化74例,无心脏瓣膜钙化174例。低镁血症组患者心脏瓣膜钙化的发生率明显升高(P=0.001)。两组患者年龄、性别构成无明显差别。低血镁组患者血红蛋白、血钙、血磷、血白蛋白水平明显下降,甲状旁腺激素明显升高,差异均有统计学意义(P0.05)。两组患者三酰甘油、胆固醇水平无明显差别。血镁水平与血红蛋白、血钙、血磷、质子泵抑制剂及利尿剂使用相关。对263例患者进行3~21个月不等的随访,发生心血管不良事件68例。COX分析显示心血管事件的发生与低血镁、心脏瓣膜钙化有关(P0.05)。结论 CKD患者低镁血症发生率高,可能参与心血管事件的发生与发展。
[Abstract]:Objective to investigate the changes of serum magnesium and its influencing factors in patients with chronic kidney disease (CKD) and to explore the correlation with cardiovascular events. Methods 381 patients with stage 3 CKD were selected, including 293 inpatients and 88 patients with maintenance hemodialysis. According to the serum magnesium level, the patients were divided into low blood magnesium group and non-hypoglycemic magnesium group, and cardiac color Doppler ultrasound was used to evaluate the calcification of heart valve. The patients were followed up for 3 ~ 21 months, median 13 months, and any cardiovascular events were recorded. Results among 381 cases of CKD, 50 cases had stage 5 of CKD 3 or 4, 331 cases had stage 5 of CKD. There were 121 cases of hypomagnesemia with 31. 76D, 245 cases of normal blood magnesium with 64.30%, 15 cases with hypermagnesium and 3. 94 cases with hypomagnesemia and 248 cases with hypersensitivity, 74 cases with calcification of heart valve and 174 cases without calcification of heart valve. The incidence of cardiac valve calcification in hypomagnesemia group was significantly increased. There was no significant difference in age and sex composition between the two groups. The levels of hemoglobin, serum calcium, serum phosphorus, albumin and parathyroid hormone in low magnesium group were significantly lower than those in control group (P 0.05). There was no significant difference in triglyceride and cholesterol levels between the two groups. Serum magnesium levels were associated with hemoglobin, serum calcium, blood phosphorus, proton pump inhibitors and diuretic use. 263 patients were followed up for 3 ~ 21 months, 68 patients with cardiovascular adverse events. Cox analysis showed that the occurrence of cardiovascular events was related to low blood magnesium and cardiac valve calcification (P 0.05). Conclusion the incidence of hypomagnesemia in CKD patients is high and may be involved in the occurrence and development of cardiovascular events.
【作者单位】：安徽医科大学第二附属医院肾脏内科;太和县中医院肾脏内科;安徽医科大学第四附属医院肾脏内科;
【基金】：安徽省卫生厅医学科研课题(编号:09C152) 安徽省高等学校省级自然科学研究项目(编号:KJ2013Z155) 安徽医科大学2015年度校临床科学研究项目(编号:2015xkj110)
【分类号】：R692

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