老年维持性血液透析患者脂联素水平与心脑血管事件及生存率的相关性  

Association of adiponectin level with MACCE and survival rate in elderly patients on hemodialysis

作　　者：杜晓娅[1] 吕莉娜 魏磊[1] 侯存 刘金荣[1] 庞隐[1] 

机构地区：[1]济宁市第一人民医院肾内科,272100

出　　处：《中华老年心脑血管病杂志》2014年第9期932-934,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年血液透析患者脂联素水平与主要不良心脑血管事件(MACCE)及生存率的相关性。方法选择79例老年血液透析患者,检测脂联素水平,以正常值下线5mg/L为界,≥5mg/L为高脂联素组44例,<5mg/L为低脂联素组35例。记录随后3年患者的死亡时间及原因;用Kaplan-Meier方法分析无MACCE生存率;Cox回归分析脂联素及其他因素对患者长期预后的影响。结果随访期间,低脂联素组共发生MACCE 25例次,6、12、24和36个月无MACCE生存率分别为77.1%、65.7%、42.9%和28.6%,脂联素有逐渐下降趋势,24、36个月下降更明显(P<0.01);高脂联素组共发生MACCE 18例次,无MACCE生存率分别为88.6%、72.7%、59.1%和38.6%。生存分析显示,2组生存率比较,差异有统计学意义(P<0.01),Cox单因素分析,脂联素是影响患者远期预后的独立危险因素(P<0.05)。结论随访过程中,低脂联素组伴随脂联素水平的降低,MACCE逐渐增多。脂联素可作为老年血液透析患者MACCE的良好预测指标,并与远期生存率相关,有较好的临床应用价值。Objective To study the association of serum adiponectin（APN）level with MACCE and survival rate in elderly patients on hemodialysis.Methods Seventy-nine elderly patients on hemodialysis were enrolled in this study.Their APN level was measured.The patients were divided into APN≥5mg/L group（n=44）and APN〈5mg/L group（n=35）.The patients were followed up for 3years during which the time and reasons of death were recorded.Their MACCE-free survival rate was analyzed with the Kaplan-Meier method.The effect of APN level and other factors on their long-term outcome was analyzed by Cox regression analysis.Results MACCE occurred 25times/cases in APN5mg/L group during the follow-up.The MACCE-free survival rate was77.1%,65.7%,42.9%and 28.6%for 6,12,24 and 36months,respectively.The ANP level decreased gradually,especially in 24 and 36months（P〈0.01）.MACCE occurred 18times/cases in ANP≥5mg/L group during the follow-up.Their MACCE-free survival rate was 88.6%,72.7%,59.1%and 38.6% was for 6,12,24 and 36months,respectively.No significant change was found in their APN level（P〈0.05）.Survival analysis showed that the survival rate was different in two groups（P〈0.01）.Cox univariate analysis showed that ANP level was an independent risk factor for the long-term outcome in elderly patients（P〈0.05）.Conclusion The incidence of MACCE increases with the decreasing APN level in those with their APN5mg/L.APN level can be used as a predictor for MACCE and long-term survival rate in elderly patients on hemodialysis.

关 键 词：肾透析 脂联素 动脉粥样硬化 肾病 心肌梗死 卒中 

分 类 号：R692.5[医药卫生—泌尿科学]