维持性血液透析患者腹主动脉钙化的危险因素  

Analysis of risk factors associated with abdominal aortic calcification in maintenance hemodialysis patients

作　　者：杨洁[1] 陈天怡 王玲[2] YANG Jie;CHEN Tian-Yi;WANG Ling(Department of Nephrology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院肾内科,北京100035 [2]北京积水潭医院放射科,北京100035

出　　处：《中国老年学杂志》2021年第16期3467-3471,共5页Chinese Journal of Gerontology

基　　金：国家自然科学基金(81870524)。

摘　　要：目的评估维持性血液透析(MHD)患者腹主动脉钙化(AAC)的危险因素。方法纳入北京积水潭医院MHD患者86例,通过腹部CT平扫定量评估AAC。根据AAC评分中位数(54分)将患者分为轻度AAC组(<54分)和重度AAC组(≥54分),通过多因素Logistic回归模型,分析AAC加重的危险因素。结果MHD患者AAC发生率为93.02%(95%CI 86.05%~97.51%)。重度AAC组的年龄、透析龄、血钙、血磷、全段甲状旁腺激素均显著高于轻度AAC组,而血清铁蛋白则显著低于轻度组(P<0.05)。高龄(OR=1.085)、长透析龄(OR=1.015)、血磷升高(OR=13.133)、血钙升高(OR=93.854)是AAC加重的独立危险因素,高血清铁蛋白是其保护因素(OR=0.944)。结论MHD患者AAC发生率高,高龄、长透析龄、血磷升高、血钙升高是AAC加重的危险因素,高血清铁蛋白为保护因素。Objective To evaluate the risk factors for abdominal aortic calcification(AAC)in maintenance hemodialysis(MHD)patients.Methods 86 MHD patients in Beijing Jishuitan Hospital were enrolled,and their AAC were quantitatively assessed by plain abdominal CT.According to AAC score,the P50 percentile(54 points)was the cutoff point,and the patients were divided into mild AAC group(<54 points)and severe AAC group(≥54 points).The risk factors of AAC were analyzed by multi-factor Logistics regression model.Results The prevalence of AAC was 93.02%(95%CI 86.05%~97.51%).Age,dialysis age,serum calcium,serum phosphorus and intact parathyroid hormone in severe AAC group were significantly higher than those in mild AAC group,while serum ferritin was lower than that in mild AAC group,and the difference was statistically significant(P<0.05).Advanced age(OR=1.085),long dialysis age(OR=1.015),hyperphosphatemia(OR=13.133)and hypercalcemia(OR=93.854)were independent risk factors of AAC,and high serum ferritin was its protective factor(OR=0.944).Conclusions The prevalence of AAC in MHD patients is high.Advanced age,long dialysis age,hyperphosphatemia and hypercalcemia are the risk factors of AAC,and high serum ferritin is the protective factor.

关 键 词：维持性血液透析 腹主动脉钙化 年龄 血磷 血钙 血清铁蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]