我院维持性血液透析和腹膜透析患者的血管钙化情况比较  

Comparison of vascular calcification in maintenance hemodialysis and peritoneal dialysis patients in our hospital

作　　者：白丽 秦纪平 荆力宝 黄红燕 朱淳 BAI Li;QIN Ji-ping;JING Li-bao(Department of Nephrology,Xinhua Hospital Chongming Branch,Shanghai 202150,China)

机构地区：[1]新华医院崇明分院肾脏内科,202150 [2]北京大学人民医院青岛医院(城阳二医)血液净化科,266111 [3]上海交通大学医学院附属新华医院肾脏内科,200092

出　　处：《中国现代药物应用》2022年第22期32-35,共4页Chinese Journal of Modern Drug Application

摘　　要：目的比较本院维持性血液透析(MHD)和腹膜透析(PD)患者的血管钙化情况。方法223例终末期肾脏病患者,按照透析方法的不同分为MHD组(165例)和PD组(58例)。比较两组患者临床资料、生化指标指标,腹主动脉钙化情况,心脏瓣膜钙化、左心室射血分数<60%及不良心血管事件发生率。结果PD组收缩压(138.00±10.78)mm Hg(1 mm Hg=0.133 kPa)、舒张压(73.52±6.35)mm Hg、血磷(1.59±0.72)mmol/L、脂蛋白a(563.9±11.7)mg/L、血白蛋白(31.44±4.09)g/L均低于MHD组的(156.36±12.02)mm Hg、(86.06±9.56)mm Hg、(2.12±0.96)mmol/L、(812.7±16.3)mg/L、(38.61±3.38)g/L,差异有统计学意义(P<0.05)。PD组患者腹主动脉钙化情况优于MHD组,差异有统计学意义(P<0.05)。PD组心脏瓣膜钙化发生率为41.4%,左心室射血分数<60%发生率为17.2%,不良心血管事件发生率为13.8%;MHD组心脏瓣膜钙化发生率为58.2%,左心室射血分数<60%发生率为30.9%,不良心血管事件发生率为26.7%。PD组心脏瓣膜钙化、左心室射血分数<60%及不良心血管事件发生率均低于MHD组,差异具有统计学意义(P<0.05)。结论血管钙化在肾脏替代治疗患者中很普遍,PD患者血压控制情况、不良心血管事件发生率、血管钙化发生率均优于MHD,但容易丢失血白蛋白。Objective To compare the vascular calcification in maintenance hemodialysis(MHD)and peritoneal dialysis(PD)patients in our hospital.Methods A total of 223 patients with end-stage kidney disease were divided into MHD group(165 cases)and PD group(58 cases)according to different dialysis methods.The clinical data,biochemical indicators,abdominal aortic calcification,cardiac valve calcification,left ventricular ejection fraction<60%and the incidence of adverse cardiovascular events were compared between the two groups.Results In the PD group,the systolic blood pressure was(138.00±10.78)mm Hg(1 mm Hg=0.133 kPa),the diastolic blood pressure was(73.52±6.35)mm Hg,the blood phosphorus was(1.59±0.72)mmol/L,the lipoprotein a was(563.9±11.7)mg/L,and the serum albumin was(31.44±4.09)g/L,which were lower than(156.36±12.02)mm Hg,(86.06±9.56)mm Hg,(2.12±0.96)mmol/L,(812.7±16.3)mg/L,and(38.61±3.38)g/L in the MHD group,and the differences were all statistically significant(P<0.05).The abdominal aortic calcification in the PD group was better than that in the MHD group,and the difference was statistically significant(P<0.05).In the PD group,the incidence of cardiac valve calcification was 41.4%,the incidence of left ventricular ejection fraction<60%was 17.2%,and the incidence of adverse cardiovascular events was 13.8%;in the MHD group,the incidence of cardiac valve calcification was 58.2%,the incidence of left ventricular ejection fraction<60%was 30.9%,and the incidence of adverse cardiovascular events was 26.7%.The incidences of cardiac valve calcification,left ventricular ejection fraction<60%and incidence of adverse cardiovascular events in the PD group were lower than those in the MHD group,and the differences were all statistically significant(P<0.05).Conclusion Vascular calcification is common in patients on renal replacement therapy,and PD patients have better blood pressure control,incidence of adverse cardiovascular events,and incidence of vascular calcification than MHD,but are prone to loss of blood albumin.

关 键 词：维持性血液透析 腹膜透析 血管钙化 不良心血管事件 

分 类 号：R692.5[医药卫生—泌尿科学]