维持性血液透析患者主动脉弓钙化的危险因素分析  

The risk factors of aortic arch calcification in maintenance hemodialysis patients

作　　者：丰玲[1] 余琼斌[1] 张东亮[2] 

机构地区：[1]中国石油集团东方地球物理勘探有限责任公司第二职工医院内科,河北涿州072751 [2]首都医科大学附属北京友谊医院肾内科,100050

出　　处：《中国医师进修杂志》2013年第25期1-3,共3页Chinese Journal of Postgraduates of Medicine

基　　金：首都临床特色应用研究项目（Z121107001012138）;首都卫生发展科研专项（首发2011-2002-02）;北京市自然科学基金（7132091）

摘　　要：目的观察维持性血液透析（MHD）患者主动脉弓钙化（AoAC）的危险因素。方法对接受MHD治疗≥5年的患者进行回顾性分析，收集临床资料，并由影像学专业医师复习所有患者的胸部正位x线片，进行AoAC评分。应用Logistic回归模型分析AoAC的危险因素。将AoAC阳性组（29例）与AoAC阴性组（37例）各临床参数进行对比。结果共有66例患者（男21例，女45例）纳入观察，透析第0—5年的年度AoAC评分分别为（O．01340±0．07496）、（O．01890±0．07855）、（0．11850±0．17006）、（0．15700±0．20755）、（0．16600±0．20537）、（0．17550±0．22229）分，与透析第0年相比，从透析第3年起AoAC评分差异有统计学意义（Z值分别为-3．984、-4．021、-4．017，P〈0．01）。Logistic回归模型分析结果显示，只有起透年龄是AoAC的危险因素（相对风险1．177，回归系数0．163，P=0．002）。AoAC阳性组起透年龄、糖尿病肾病比例、血清钙磷乘积明显高于AoAC阴性组[（59．5±12．6）岁比（52．9±13．2）岁、27．6％（8／29）比2．7％（1／37）、（5．81±1．63）mmolZ／L2比（4．13±0．86）mmol^2／L^2]，差异有统计学意义（P〈O．05）。结论随着透析时间的延长AoAC会进行性加重，起透年龄越大AoAC的危险性越高。Objective To study the risk factors of aortic arch calcification （AoAC） in maintenance hemodialysis （MHD） patients. Methods Retrospective analysis was performed in patients who accepted MHD ≥ 5 years. The clinical data were collected. The images of plan chest radiograph detected during followup period were reviewed by certain imaging physicians,and the AoAC score was calculated. Logistic regression model analysis was proceeded to study the risk factors of AoAC. The patients were divided into AoAC positive group （29 cases） and AoAC negative group （37 cases） respectively. The clinical parameters were compared between the 2 groups. Results Sixty-six patients （21 male,45 female） were selected. The year AoAC scores from the zeroth to fifth year were （0.013 40 ± 0.074 96）, （0.018 90 ± 0.078 55 ）, （0.118 50 ± 0.170 06 ）, （0.157 00 ± 0.207 55 ）, （0.166 00 ± 0.205 37 ）, （0.175 50 ± 0.222 29） scores, progressively. There were significant differences in AoAC score from the third year compared with that of the zeroth year （Z = -3.984,-4.021 ,-4.017;P 〈 0.01 ）. I±ogistic regression model analysis result showed that only the age of dialysis beginning was the risk factor for AoAC （ relative risk 1.177, regression coefficient 0.163, P = 0.002 ）.The age of dialysis beginning,rate of diabetic nephropathy,serum calcium-phosphate product were significantly higher in AOAC positive group than that in AoAC negative group [（59.5 ± 12.6） years vs. （52.9 ± 13.2） years,27.6%（8/29） vs. 2.7%（1/37）, （5.81 ± 1.63） mmol^2/L^2 vs. （4.13 ± 0.86） mmol2/L2]. Conehmions The AoAC will aggravate with the increased duration of dialysis in MHD patients. The age of dialysis beginning is the risk factor of AoAC.

关 键 词：肾透析 钙质沉着症 主动脉 肾病 危险因素 

分 类 号：R459.5[医药卫生—治疗学]