心踝血管指数对腹膜透析患者动脉硬化的预测价值及相关影响因素
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(安徽医科大学第一附属医院1.肾脏内科,;2.心电心功能室,安徽省合肥市 230022)

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吴启美,硕士研究生,住院医师,主要从事肾脏内科研究工作,E-mail为 1522859891@qq.com。

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Predictive value and risk factors of cardio-ankle vascular index in arterial stiffness in peritoneal dialysis patients
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1.Department of Nephrology, ;2.Cardio-cardiac Function Room, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China)

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    摘要:

    目的 评估心踝血管指数在腹膜透析患者动脉硬化中的应用价值及相关影响因素。 方法 选择95例维持性腹膜透析患者,收集患者的基本信息和实验室指标,同时测定患者的心踝血管指数(CAVI)。根据CAVI是否升高分为高CAVI组(CAVI≥9)和正常CAVI组(CAVI<9)。 结果 高CAVI组CAVI(9.85±0.73)明显高于正常CAVI组(7.67±0.81),高CAVI组年龄(54.64±5.68岁)、透析时间(48.32±30.43月)、脉压(57.41±12.43 mmHg)、血清矫正钙(2.52±0.28 mmol/L)、血磷(2.22±0.66 mmol/L)、钙磷乘积(5.59±1.70)、空腹血糖(6.02±1.83 mmol/L)明显高于正常CAVI组,血红蛋白(83.96±20.53 g/L)、血白蛋白(32.40±5.22 g/L)明显低于正常CAVI组。Spearman相关分析显示腹膜透析患者CAVI与年龄、透析时间、脉压、血清矫正钙、血磷、钙磷乘积、空腹血糖、高敏C反应蛋白呈正相关(r值分别为0.520、0.260、0.244、0.347、0.231、0.338、0.225、0.298,P均<0.05),与血白蛋白、25-羟维生素D呈负相关(r值分别为-0.335、-0.222,P均<0.05);多元线性回归分析显示年龄、血白蛋白是腹膜透析患者CAVI的独立危险因素。 结论 心踝血管指数可以作为评价腹膜透析患者动脉硬化的无创检测指标,早期检测心踝血管指数、改善营养状况可以降低腹膜透析患者动脉硬化发生风险,减少心血管疾病的发生,改善预后。

    Abstract:

    Aim To evaluate application value and analyze risk factors of cardio-ankle vascular index (CAVI) in arterial stiffness in peritoneal dialysis patients. Methods A total of 95 patients with end-stage kidney disease undergoing peritoneal dialysis were enrolled, baseline characteristics and laboratory measurements were collected, and CAVI was determined. According to CAVI, the patients were divided into high CAVI group (CAVI≥9) and normal CAVI group (CAVI<9). Results The CAVI was significantly higher in high CAVI group (9.85±0.73) than that in normal CAVI group (7.67±0.81). The age (54.64±5.68 years), dialysis duration (48.32±30.43 months), pulse pressure (57.41±12.43 mmHg), serum correctional calcium (2.52±0.28 mmol/L), phosphorus (2.22±0.66 mmol/L), calcium-phosphorus product (5.59±1.70), fasting blood glucose (6.02±1.83 mmol/L) were significantly higher in high CAVI group than those in normal CAVI group, hemoglobin (83.96±20.53 g/L) and serum albumin (32.40±5.22 g/L) were significantly lower in high CAVI group than those in normal CAVI group.Spearman correlation analysis showed that CAVI was positively correlated with age, dialysis duration, pulse pressure, serum correctional calcium, phosphorus, the calcium-phosphorus product, fasting blood glucose, hs-CRP(r values were 0.0,0.0,0.4,0.7,0.1,0.8,0.5,0.298 respectively, each P<0.05), and negatively with serum albumin, 25-hydroxyvitamin D (r values were -0.335, -0.222, each P<0.05). Multiple linear regression analysis showed that age and serum albumin were independent risk factors of CAVI. Conclusion CAVI can be used as an index of noninvasive detection of atherosclerosis in patients with peritoneal dialysis, early detection of CAVI and improving nutrition can reduce the risk of atherosclerosis in peritoneal dialysis patients, the incidence of cardiovascular events, and improve the prognosis.

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吴启美,卢文,郑林林.心踝血管指数对腹膜透析患者动脉硬化的预测价值及相关影响因素[J].中国动脉硬化杂志,2017,25(12):1269~1272.

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  • 收稿日期:2017-06-30
  • 最后修改日期:2017-08-09
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  • 在线发布日期: 2017-12-28