血液透析患者角膜和结膜钙化与腹主动脉钙化的相关性研究  

Conjunctival and corneal calcificationin is associated with abdominal aortic calcification in maintenance haemodialysis patients

作　　者：孙梅[1] 孙文学[1] 刘毅[1] 马璐璐[1] 刘银和[2] 董丽卿[3] 徐玉兰[1] 许菲菲[1] 

机构地区：[1]温州医科大学附属第一医院肾内科,325000 [2]温州医科大学附属第一医院眼科,325000 [3]温州医科大学附属第一医院放射科,325000

出　　处：《中华肾脏病杂志》2014年第8期565-569,共5页Chinese Journal of Nephrology

基　　金：温州市科技计划项目（Y20120020）.

摘　　要：目的探讨维持性血液透析（MHD）患者角膜和结膜钙化与血管钙化之间的关系。方法应用裂隙灯检查角膜和结膜钙化（CCC）的情况并量化评分，采用腹部侧位X线平片评判患者腹主动脉钙化（AAC）情况。Spearman相关性分析角膜和结膜钙化与腹主动脉钙化之间的相关性，用logistic回归方法分析MHD患者发生角膜和结膜钙化的危险因素。结果（1）共入选98例MHD患者，平均年龄（61．89±12．54）岁，透析龄51．67（3．00～192．00）月，其中97例存在CCC，中位CCC评分为8（0，17）；72例存在AAC，中位AAC评分为6（O，20），CCC和AAC之间的Spearman等级相关系数为0．376（P＜0．001）；（2）与CCC≤5分组患者相比，CCC＞10分组患者的血磷水平、钙磷乘积、全段甲状旁腺素（iPTH）、超敏C反应蛋白（hs－CRP）、低密度脂蛋白（LDL）水平较高，透析龄较长（均P＜0．05）；CCC评分高的患者AAC评分亦较高（P＜0．05）。（3）多因素logistic回归分析结果显示：AAC评分和透析龄是角膜和结膜钙化的独立危险因素。结论MHD患者普遍存在角膜和结膜钙化，CCC与AAC问呈正相关关系，腹主动脉钙化越重，透析时间越长，发生角膜和结膜钙化的风险也越高。Objective To determine the condition of conjunctival and corneal calcificationin in maintenance haemodialysis patients, and explore the relationship between conjunetival and corneal calcificationin （CCC） and abdominal aortic calcification （AAC）. Methods CCC was evaluated by slitlamp eye photographs, and was graded and scored according to Porter＇s classification system in the literature. Abdomen lateral X-ray examination were used as a criteria to determine the abdominal aortic calcification. The abdominal aortic calcification （AAC） score was calculated. Spearman correlation coefficient was used to analyze the relationship between CCC and AAC. Logistic regression analysis was used to determine the risk factor of CCC in MHD patients. Results Ninety-eight MHD patients were recruited. Their average age and dialysis vintage were （61.89±12.54） years and 51.67 （3.00～192.00） months, ninety-seven patients had conjunctival and corneal calcificationin, and seventy-two patients had abdominal aortic calcification, The median CCC was 8 （0, 17）, the median AAC was 6 （0, 20）, and the CCC was positively correlated with AAC （r=0.376, P〈0.001）. Compared with the patients of CCC score≤5, the patients of CCC score〉 10 had a higher level of phosphate, calcium-phosphate product, iPTH, hs-CRP, and longer dialysis vintage, as well as a higher score of AAC （all P〈0.05）. Multivariatelogistic regression analysis showed that the higher score of AAC and the longer dialysis vintage were independent risk factors for severe corneal calcificationin calcification. Conclusions Conjunctival and corneal calcificatinnin is common in MHD patients, and CCC is positively associated with AAC, the risk of CCC rises as a result of a severer AAC and a longer dialysis vintage.

关 键 词：血液透析 转移性钙化 钙化 角膜和结膜 钙化 腹主动脉 

分 类 号：R459.5[医药卫生—治疗学]