维持性血液透析患者心脏瓣膜钙化的评价及影响因素研究  

Evaluation and Influencing Factors of Cardiac Valve Calcification in Maintenance Hemodialysis Patients

作　　者：张月倩 ZHANG Yue-qian(Department of Functional Inspection,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China)

机构地区：[1]天津市中医药研究院附属医院功能检查科,天津300120

出　　处：《医学信息》2023年第3期125-128,共4页Journal of Medical Information

摘　　要：目的探讨维持性血液透析(MHD)患者心脏瓣膜钙化(CVC)情况及其影响因素。方法选择2019年1月-2021年8月本院收治的102例伴CVC的MHD患者,经超声心动图检查行心脏瓣膜钙化积分(CVCs)评定,并将其分为轻、中、重度钙化组,比较3组性别、年龄、透析龄、高血压史、糖尿病史、吸烟史、体重指数(BMI)、血肌酐、尿素氮、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血清白蛋白、全段甲状旁腺激素(iPTH)、血清钙、血清磷及钙磷乘积水平,评估其与CVC分级的关系,分析CVCs与上述临床资料的相关性,多因素有序Logistic回归分析CVC的独立危险因素。结果3组透析龄、血钙、血磷、钙磷乘积比较,差异有统计学意义(P<0.05),其中重度钙化组透析龄较轻度钙化组及中度钙化组更长,重度钙化组血钙、血磷、钙磷乘积较轻度钙化组高;Spearman相关分析显示,MHD患者的CVCs与年龄、透析龄、iPTH、血钙、血磷、钙磷乘积呈正相关(r=0.272、0.459、0.247、0.453、0.503、0.531);多因素有序Logistic回归分析显示,血磷水平为MHD患者CVC的独立危险因素(P<0.05)。结论高龄、较长透析龄、高钙、高磷、iPTH、钙磷乘积均与CVC的发生相关,其中高磷是MHD患者CVC的独立危险因素。Objective To investigate the cardiac valve calcification(CVC)and its influencing factors in maintenance hemodialysis(MHD)patients.Methods A total of 102 MHD patients with CVC admitted to our hospital from January 2019 to August 2021 were selected.The cardiac valve calcification scores(CVCs)were evaluated by echocardiography,and they were divided into mild,moderate and severe calcification groups.The gender,age,dialysis age,history of hypertension,history of diabetes,smoking history,body mass index(BMI),serum creatinine,urea nitrogen,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,serum albumin,intact parathyroid hormone(iPTH),serum calcium,serum phosphorus and calcium-phosphorus product levels were compared among the three groups,and their relationship with CVC grading was evaluated.The correlation between CVCs and the above clinical data was analyzed,and the independent risk factors of CVC were analyzed by multivariate ordinal logistic regression.Results There were significant differences in dialysis age,serum calcium,serum phosphorus and calcium-phosphorus product among the three groups(P<0.05).The dialysis age of severe calcification group was longer than that of mild calcification group and moderate calcification group,and the serum calcium,serum phosphorus and calcium-phosphorus product of severe calcification group were higher than those of mild calcification group.Spearman correlation analysis showed that CVCs in MHD patients were positively correlated with age,dialysis age,iPTH,serum calcium,serum phosphorus and calcium-phosphorus product(r=0.272,0.459,0.247,0.453,0.503,0.531).Multivariate ordinal logistic regression analysis showed that serum phosphorus level was an independent risk factor for CVC in MHD patients(P<0.05).Conclusion Advanced age,longer dialysis age,high calcium,high phosphorus,iPTH,calcium-phosphorus product are all related to the occurrence of CVC,and high phosphorus is an independent risk factor for the CVC in MHD patients.

关 键 词：心脏瓣膜钙化 维持性血液透析 超声检查 

分 类 号：R318.16[医药卫生—生物医学工程]