老年慢性肾病患者危险因素分析  

The Analysis on the Risk Factors for Elderly Chronic Kidney Disease Patients

作　　者：沈展[1] 汪思阳[1] 沈婷婷[1] 邱凌[1] 曲毅[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,上海200031

出　　处：《医学综述》2014年第14期2670-2672,共3页Medical Recapitulate

摘　　要：目的 探讨老年慢性肾脏疾病（CKD）的相关危险因素,为老年CKD患者的早期评估与治疗提供依据.方法 选取2011年1月至2013年12月在上海市徐汇区中心医院老年科住院的100例CKD患者（CKD组）和100例非CKD患者（非CKD组）,记录两组患者的动脉硬化程度（脉搏波速度,踝臂指数）、内皮功能（一氧化氮、内皮素）指标数据,收集患者的心血管危险因素和心血管事件的发生情况.结果 CKD组脉搏波速度显著高于非CKD组[（1955.12±254.48） cm/s vs（1480.46±235.12）c m/s]（P＜0.05）,踝臂指数显著低于非CKD组[（1.005±0.114） vs（1.297±0.112）]（P ＜0.05）;CKD组血浆一氧化氮水平显著低于非CKD纽（49.7±5.5） μmol/L vs（58.1±7.9） μmol/L]（P＜0.05）,内皮素水平显著高于非CKD组[（66.2±9.6） ng/L vs（51.3±10.2）ng/L]（P＜0.05）.Logistic回归分析结果显示CKD的危险因素包括动脉硬化（OR =2.233,95％CI1.706～2.551）、内皮功能紊乱（OR =1.761,95％ CI0.913～3.217）、心血管事件（OR =3.067,95％ CI1.388～6.431）.结论 CKD患者心血管事件发生率高,动脉硬化程度重且多合并有内皮功能紊乱,需提早发现及干预.Objective To investigate the risk factors for the elderly patients with chronic kidney disease （CKD）,to provide references for early assessment and treatment of CKD.Methods A total of 100 CKD cased CKD group） and 100 patients without CKD（non-CKD group） in Shanghai Xuhui District Central Hospital between Jan.2011 and Dec.2013 were retrospectively analyzed.The degree of hardening of the arteried pulse wave velocity,ankle arm index）,endothelial function（nitric oxide,endothelin） of two groups were detected and recorded.The cardiovascular risk factorrs and the occurrence of cardiovascular events were collected.Results The PWV in CKD group was significantly higher than the non-CKD group[（1955.12 ± 254.48） cm/s vs （1480.46 ± 235.12） cm/s,P 〈 0.05],ankle arm index in CKD group was significantly lower than the non-CKD group with statistically significant difference[（1.005 ± 0.114） vs （1.297 ± 0.112）,P 〈 0.05];CKD group plasma NO level was significantly lower than the non-CKD group[（49.7 ± 5.5） μmol/L vs （58.1 ± 7.9） μmol/L,P 〈 0.05],ET level was significantly higher than the non-CKD group[（66.2 ± 9.6） ng/L vs （51.3 ± 10.2） ng/L,P 〈 0.05].Logistic regression showed that the risk factors of CKD included arteriosclerosid OR=2.233,95 % CI 1.706-2.551）,endothelial dysfunction （OR =1.761,95% CI0.913-3.217）and cardiovascular complications（OR =3.067,95% CI 1.388-6.431）.Conclusion Patients with CKD have a higher incidence of cardiovascular events; the artery sclerosis and endothelial dysfunction are much severer in CKD patients;early detection and intervention are needed.

关 键 词：慢性肾脏疾病 动脉硬化 内皮功能紊乱 心血管并发症 

分 类 号：R543[医药卫生—心血管疾病]