维持性血液透析患者血浆可溶性CD40配体水平与心血管事件的关系研究  

Relationship between Soluble CD40 Ligand Level and Cardiovascular Events in Maintenance Hemodialysis Patients

作　　者：姜立萍[1] 黄雯[1] 刘宁[1] 

机构地区：[1]首都医科大学附属北京同仁医院肾内科,北京市100730

出　　处：《中国全科医学》2011年第3期236-238,共3页Chinese General Practice

摘　　要：目的探讨维持性血液透析(MHD)患者血浆可溶性CD40配体(sCD40L)水平与心血管事件的关系。方法选择我院MHD患者48例,进行sCD40L和相关因素的检测。根据观察开始时sCD40L水平(高于或低于中位数154μg/L)分为两组,所有患者随访时间为36个月,记录随访期间MHD患者心血管事件(包括心力衰竭或急性冠脉综合征)发生情况。结果在36个月随访期内,48例MHD患者发生心血管事件79例次,心血管事件死亡14例,死亡率为29.2%。sCD40L高水平组心血管事件发生率及心血管事件死亡率明显高于sCD40L低水平组,差异均有统计学意义(P<0.05);Kaplan-Meier生存分析显示,36个月生存率sCD40L高水平组较sCD40L低水平组显著降低(P<0.05)。经Cox多因素回归分析,sCD40L水平(>154μg/L)与心血管事件发生风险显著相关(RR=5.52,P=0.01)。结论 sCD40L水平升高是MHD患者心血管事件发生的独立危险因素,也是判断MHD患者预后的重要预测因子。Objective To investigate the relationship between soluble CD40 ligand （sCD40L） level and cardiovascular events in maintenance hemodialysis （MHD） patients. Methods 48 MHD patients were enrolled in this study. Plasma sCD40L and related parameters were measured at the beginning of study. MHD patients were divided in two groups according to sCD40L level above or below the median （ 154 μg/L）. The patients were followed up for 36 months. Cardivascular events （including cardiac failure or acute coronary syndrome） were recorded during the period. Results During the 36 months follow up period, 48 MHD patients occurred cardiovascular event 79 times, and 14 patients died （29. 2% ）. Frequency of cardiovascular events and cardiovascular mortality rate were significantly higher in the high level sCD40L group than in the low level sCD40L group （P 〈0.05 ）. Kaplan -Meier analysis showed survival rate was significantly lower in the high level sCD40L group than in the low level sCD40L group （P 〈0. 05）. The sCD40L level （ 〉 154 μg/L） was significantly associated with the occurrence of cardiovascular events by muhiple Cox regression analysis （RR = 5.52, P = 0. 01 ）. Conclusion The elevated sCD40L level is the independent risk factor for cardiovascular events, and is also an important predictor for prognosis in MHD patients.

关 键 词：肾透析 可溶性CD40配体 心血管事件 生存率 

分 类 号：R459.52[医药卫生—治疗学]