在线血液透析滤过患者血清铁蛋白表达与心血管事件的相关性分析  

Correlation analysis of serum ferritin expression and cardiovascular events in online hemodiafiltration patients

作　　者：张宝桐 郭冬慈 富丽 朱丹 解冬杰 Zhang Baotong;Guo Dongci;Fu Li;Zhu Dan;Xie Dongjie(Hemodialysis Room, Liaoyang Central Hospital, Liaoning Pro-vince, Liaoyang 111000, China)

机构地区：[1]辽宁省辽阳市中心医院血液透析室,111000

出　　处：《疑难病杂志》2022年第2期178-181,187,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省科学研究项目(L201702)。

摘　　要：目的观察经在线血液透析滤过(OL-HDF)治疗患者血清铁蛋白(SF)表达水平及其与心血管事件发生的相关性。方法选取2015年10月—2017年10月辽阳市中心医院血液透析中心行OL-HDF治疗患者113例,根据随访过程中是否发生心血管事件分为对照组(未发生,65例)、观察组(发生,48例)。采用电化学发光法测定患者治疗前后血清铁蛋白表达水平;通过二元Logistic回归分析OL-HDF治疗患者心血管事件发生危险因素;绘制受试者工作特征曲线(ROC)分析血清SF表达对OL-HDF治疗患者心血管事件发生的预测价值。结果观察组收缩压、空腹血糖、TG、LDL-C及血尿酸高于对照组,差异均有统计学意义(P<0.05)。治疗后2组患者血清铁蛋白水平及尿素氮、血肌酐、β_(2)-微球蛋白水平均低于治疗前,且观察组均高于对照组(t/P=9.059/<0.001、13.486/<0.001、10.042/<0.001、22.025/<0.001)。血清铁蛋白、收缩压、空腹血糖、LDL-C、血尿酸升高均是OL-HDF治疗患者心血管事件发生的危险因素[OR(95%CI)=1.421(1.123~1.798)、2.525(1.730~3.684)、2.102(1.599~2.763)、2.751(1.851~4.090)、1.697(1.826~1.577)]。血清铁蛋白表达预测OL-HDF治疗患者心血管事件发生的ROC曲线下面积为0.828,敏感度为0.729,特异度为0.923,约登指数为0.652。结论血清铁蛋白表达可作为预测OL-HDF治疗患者心血管事件发生的指标。Objective To observe the expression level of serum ferritin(SF)in patients treated with online hemodiafiltration(OL-HDF)and its correlation with cardiovascular events.Methods A total of 113 patients with OL-HDF in the Hemodialysis Center of Liaoyang Central Hospital from October 2015 to October 2017 were selected and divided into control group(none,65 cases),observation group(occurring,48 cases).The expression levels of serum SF in patients before and after treatment were determined by electrochemiluminescence.The risk factors of cardiovascular events in patients treated with OL-HDF were analyzed by binary logistic regression.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum SF expression on cardiovascular events in patients treated with OL-HDF.Results The systolic blood pressure,fasting blood glucose,TG,LDL C and serum uric acid in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum SF,blood urea nitrogen,serum creatinine and β_(2) microglobulin in the two groups were lower than those before treatment,but the observation group was significantly higher than the control group(t/P=9.059/<0.001,13.486/<0.001,10.042/<0.001,22.025/<0.001).Serum SF,systolic blood pressure,fasting blood glucose,LDL-C,and elevated serum uric acid were all risk factors for cardiovascular events in patients treated with OL-HDF[OR(95%CI)=1.421(1.123-1.798),2.525(1.730-3.684),2.102(1.599-2.763),2.751(1.851-4.090),1.697(1.826-1.577)].The area under the ROC curve of SF expression for predicting cardiovascular events in OL-HDF-treated patients was 0.828,the sensitivity was 0.729,the specificity was 0.923,and the Youden index was 0.652.Conclusion Serum SF expression can be used as a predictor of cardiovascular events in OL-HDF-treated patients.

关 键 词：心血管事件 在线血液透析滤过 铁蛋白 相关性 

分 类 号：R459.5[医药卫生—治疗学] R541[医药卫生—临床医学]