维持性血液透析糖尿病肾病患者冠状动脉钙化的危险因素分析  

Risk factors for coronary artery calcification in patients with maintenance hemodialysis diabetic nephropathy

作　　者：邵丽娜[1] 李晔 樊伟[1] 宋锴 SHAO Li’na;LI Ye;FAN Wei;SONG Kai(Department of Nephrology,Yixing People’s Hospital,Jiangsu Province,Yixing 214200,China)

机构地区：[1]江苏省宜兴市人民医院肾脏科,江苏宜兴214200

出　　处：《中国医药导报》2021年第20期55-58,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20170948)。

摘　　要：目的探讨维持性血液透析(MHD)糖尿病肾病患者冠状动脉钙化(CAC)的危险因素。方法回顾性分析2018年1月至12月江苏省宜兴市人民医院行MHD的糖尿病肾病91例患者的临床资料。收集患者临床资料,根据冠状动脉钙化评分(CACs)将其分为非CAC组(28例)和CAC组(63例)。分析MHD糖尿病肾病患者CAC的危险因素。结果两组年龄、透析龄、吸烟史、血钙、全段甲状旁腺激素(iPTH)、瘙痒评分比较,差异有统计学意义(P<0.05)。年龄>60岁、有吸烟史、iPTH>302.71 pg/ml、瘙痒评分≥4分是MHD糖尿病肾病患者CAC的危险因素(OR>1,P<0.05)。结论年龄、吸烟史、iPTH、瘙痒评分是MHD糖尿病肾病患者发生CAC的独立危险因素。临床医师在治疗过程中,应注意对高危患者的识别,早期干预,提高患者临床预后,降低心血管发病率。Objective To investigate the risk factors of coronary artery calcification(CAC)in patients with maintenance hemodialysis(MHD)diabetic nephropathy.Methods Clinical data of 91 patients with diabetic nephropathy who underwent MHD in Yixing People’s Hospital of Jiangsu Province from January to December 2018 were retrospectively analyzed.The clinical data of the patients were collected and they were divided into the no-CAC group(28 cases)and CAC group(63 cases)according to the coronary artery calcification score(CACs).The risk factors of CAC in patients with MHD diabetic nephropathy were analyzed.Results There were statistically significant differences in age,dialysis age,smoking history,serum calcium,intact parathyoid hormone(iPTH)and pruritus scores between the two groups(P<0.05).Age>60 years old,smoking history,iPTH>302.71 pg/ml and pruritus score≥4 points were risk factors for CAC in patients with MHD diabetic nephropathy(OR>1,P<0.05).Conclusion Age,smoking history,iPTH and pruritus score are independent risk factors for CAC in patients with MHD diabetic nephropathy.In the course of treatment,clinicians should pay attention to the identification of high-risk patients,early intervention,improve the clinical prognosis of patients,reduce the incidence of cardiovascular disease.

关 键 词：糖尿病肾病 维持性血液透析 冠状动脉钙化 危险因素 

分 类 号：R692[医药卫生—泌尿科学]