规律血液透析患者甲状旁腺激素水平对腹主动脉钙化的效应分析
DOI:
作者:
作者单位:

作者简介:

通讯作者:

基金项目:

北京市科委首都临床特色应用与成果推广项目(215110700400000)


Effect Analysis of Parathyroid Hormone on Abdominal Aortic Calcification for Maintenance Hemodialysis Patients
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    摘要:

    目的 探讨维持性血液透析(MHD)患者腹主动脉钙化(AAC)的相关危险因素。方法 通过X线腹部侧位片对177例MHD患者进行AAC评分,按腹主动脉钙化有无将患者分为钙化组和非钙化组,比较两组患者的人口学特征、透析龄、心血管事件、高血压病史、高脂血症病史、糖尿病病史、碳酸钙及活性维生素D用药史以及血钙、血磷、全段甲状旁腺激素(iPTH)、高敏C反应蛋白(hs-CRP)等实验室指标的不同,通过Logistic回归分析AAC发生的相关危险因素,并比较不同PTH水平组患者AAC的发生率。结果 177例MHD患者中58.2%(103例)存在腹主动脉钙化,钙化组患者心血管事件的发生率显著高于非钙化组(33.3% vs 9.4%,P0.001)。单因素分析显示钙化组患者高龄、长透析龄、高hs-CRP、高脂血症、高血压、碳酸钙用药史、活性维生素D用药史人数显著高于非钙化组,差异有统计学意义(P<0.005)。Logistic回归分析显示:高龄、高脂血症、高血压、长透析龄、高iPTH、高hs-CRP、活性维生素D和碳酸钙用药史是AAC的危险因素。随着血清iPTH水平的增高,AAC的发生率也随之增加,即使在矫正了年龄、性别、吸烟、透析龄、高血压、糖尿病、高hs-CRP、活性维生素D用药史、碳酸钙用药史等影响因素后,这种作用依然存在。结论 MHD患者腹主动脉钙化发生率明显高于正常人群。研究发现年龄、高脂血症、高血压、透析龄、高PTH、高hs-CRP、活性维生素D和碳酸钙用药史是AAC的危险因素,其中高iPTH水平是MHD患者AAC的独立危险因素。

    Abstract:

    Aim To investigate the risk factors of abdominal aortic calcification(AAC) for maintenance hemodialysis(MHD) patients.Methods The lateral X-ray plain films of abdomen were used for AAC evaluation in MHD patients. 177 MHD patients were divided into calcified group(AAC>0)and non-calcified group(AAC0). The demographic characteristics,dialysis vintage,clinical history as cardiovascular events,hypertension,hyperlipidemia,diabetes,medication history of calcium carbonate and active vitamin D,laboratory markers as serum calcium,phosphorus,intact parathyroid hormone(iPTH) and hypersensitive c-reactive protein(hs-CRP) were compared between the two groups. The risk factors of AAC were analyzed by Logistic regression model. The probability of AAC among patients with different level of iPTH was evaluated.Results There are 103(58.2%) MHD patients with AAC. The incidence of cardiovascular events was significantly higher in calcified group compared with non-calcified group(33.3% vs 9.4%). The results of univariable analysis showed that the number of patients with aging,longer history of dialysis,higher levels of hs-CRP,history of hyperlipidemia or hypertension,medication history of calcium carbonate or nonselective active vitamin D in calcified group was more than that in non-calcified group. The difference was statistically significant. The results of Logistic regression analysis showed that aging,hyperlipidemia,hypertension,longer dialysis vintage,higher iPTH and hs-CRP levels,medical history of nonselective active vitamin D or calcium carbonate were risk factors of AAC. Serum iPTH level was positively correlated with the incidence of AAC even after adjusted by age,gender,smoking,dialysis vintage,history of hypertension or diabetes,high hs-CRP,medication history of nonselective active vitamin D or calcium carbonate.Conclusion The incidence of AAC is higher in MHD patients,which might affect the prognosis of cardiovascular events. Aging,hyperlipidemia,hypertension,dialysis vintage,higher hs-CRP,nonselective active vitamin D and calcium carbonate use are risk factors of AAC. The higher levesl of iPTH might be one of the most important risk factors of AAC for MHD patients.

    参考文献
    相似文献
    引证文献
引用本文

白建梅,张 凌,金承刚,张学滨,徐志宏,张 菊,李荣山.规律血液透析患者甲状旁腺激素水平对腹主动脉钙化的效应分析[J].中国动脉硬化杂志,2015,23(05):448~452.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:2015-01-13
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: