代谢综合征对血液透析患者的心血管病死亡和全因死亡的影响  

INVESTIGATION OF EFFECT OF METABOLIC SYNDROME ON HEMODIALYSIS PATIENTS' CARDIOVASCULAR MORTALITY AND ALL-CAUSE MORTALITY

作　　者：解倩[1] 张爱华[1] 朱宁[1] 范敏华[1] 

机构地区：[1]北京大学第三医院肾脏内科,北京100191

出　　处：《现代预防医学》2012年第3期765-768,共4页Modern Preventive Medicine

摘　　要：[目的]观察代谢综合征对血液透析患者心血管死亡和全因死亡的影响。[方法]收集了某院血透中心维持性血液透析患者共157例,观察36～42个月。对患者临床和实验室基本资料进行收集,记录死亡时间和原因。并对患者的体成分和营养状况进行评估。[结果]根据IDF代谢综合征定义,患者被分为代谢综合征(MS)组和无代谢综合征(non-MS)组。两组患者的心血管死亡和全因死亡差异无统计学意义(P﹥0.05)。MS组患者营养状况好于non-MS组(SGA评分,卡方检验,P=000)。白蛋白﹤37g/l和年龄﹥66岁是导致患者全因死亡率增加的独立危险因素(COX回归分析)。[结论]IDF代谢综合征未增加患者的心血管死亡和全因死亡风险,白蛋白水平下降和老年是导致患者全因死亡率增加的独立危险因素。[Objective]To investigate the influence of metabolic syndrome on hemodialysis patients’ caediovascular mortality and all-cause mortality.[Methods]157 patients were recruited in this cohort.The cohort was followed for 36-42 months.The time points and causes of mortality were documented.The definition of metabolic syndrome used was IDF criteria 2006.Nutrition statuses were assessed by subject global assessment（SGA）and laboratory parameters.[Results]Patients were divided into two groups by IDF criteria,as metabolic syndrome and non-metabolic syndrome groups.No significant difference were found in all-cause mortality and cardiovascular mortality（χ2 test,P﹥0.05）.There were more patients with normal nutrition（SGA）in MS group（χ2 test,P = 0.000）.COX multivariate analysis on mortality risk showed that independent mortality risk factors were older than 66 years and serum albumin levels below 37 g/L.[Conclusion]Metabolic syndrome does not increase the risk of cardiovascular mortality and all-cause mortality in hemodialysis patients.The independent risk factors of all-cause mortality are low albumin levels（indicating malnutrition）and old age（older than 66 years）.

关 键 词：代谢综合征 营养 血液透析 死亡率 

分 类 号：R589[医药卫生—内分泌]