血钾与2型糖尿病终末期肾病未透析患者腹主动脉钙化相关性研究  

Correlation between serum potassium and abdominal aortic calcification in type 2 diabetes patients with end-stage renal disease without dialysis

作　　者：马晓迎[1] 生玉平 杨星梦 王娜[1] 张浩然[1] 徐海平[1] 孙福云[1] MA Xiao-ying;SHENG Yu-ping;YANG Xing-meng;WANG Na;ZHANG Hao-ran;XU Hai-ping;SUN Fu-yun(Department of Nephrology,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院肾内科,河北沧州061000

出　　处：《创伤与急危重病医学》2023年第2期110-115,共6页Trauma and Critical Care Medicine

基　　金：河北省沧州市重点研发计划指导项目(204106081);2022年度河北省医学科学研究课题计划(20220332)。

摘　　要：目的探讨血钾与合并2型糖尿病(2DM)终末期肾病未透析患者腹主动脉钙化(AAC)的相关性。方法选取自2019年10月至2020年5月沧州市中心医院肾内科收治的终末期肾病未透析239例患者为研究对象,通过侧位腹平片查看AAC情况,根据是否存在AAC将患者分为AAC组(n=90)和非ACC组(n=149),比较两组患者的一般资料、血钾水平、合并2DM等情况;通过多元Logistic回归分析评估血钾同合并或非合并2DM终末期肾病患者AAC的相关性;受试者工作特征(ROC)曲线分析血钾对AAC的诊断价值。结果AAC组和非ACC组患者在年龄、舒张压、平均动脉压、尿酸,合并心脑血管疾病比例、全段甲状旁腺激素、碱性磷酸酶等比较,差异均有统计学意义(P<0.05)。与非合并2DM终末期肾病患者比较,合并2DM患者血钾偏低,但差异无统计学意义(P>0.05);与非合并2DM终末期肾病患者比较,合并2DM患者AAC积分水平和AAC积分>0分、AAC积分>5分比例明显升高,差异有统计学意义(P<0.05)。年龄与合并2DM终末期肾病患者AAC相关(P<0.05);年龄、性别、血钾、碱性磷酸酶、甲状旁腺激素及合并脑血管病与非合并2DM终末期肾病患者AAC相关(P<0.05)。Logistic回归模型分析结果显示,低血钾水平是AAC积分>5分的危险因素。ROC曲线分析结果显示,血钾诊断合并2DM终末期肾病患者AAC积分>5分的曲线下面积为0.711,95%可信区间为0.593~0.811,P=0.0019,灵敏度为69.6%,特异度为69.4%;血钾联合年龄诊断合并2DM终末期肾病患者AAC积分>5分的曲线下面积为0.793,95%可信区间为0.687~0.882,P<0.001,灵敏度为78.3%,特异度为70.0%。结论合并2DM终末期肾病患者AAC积分较高,血钾水平与合并2DM终末期肾病患者的AAC相关。Objective To investigate the relationship between serum potassium and abdominal aortic calcification(AAC)in patients with end-stage renal disease and non dialysis patients with 2 diabetes mellitus(2DM).Methods A total of 239 patients with endstage renal disease without dialysis admitted from October 2019 to May 2020 were selected as the study subjects.The AAC condition was checked by lateral abdominal plain film.The patients were divided into AAC group(n=90)and non-ACC group(n=149)according to the presence of AAC,and the general data,blood potassium level,and combination of 2DM of the two groups were compared.The correlation between serum potassium and AAC in patients with or without 2DM end-stage renal disease was evaluated by multiple logistic regression analysis.The diagnostic value of blood potassium for AAC was analyzed by the receiver operator characteristic(ROC)curve.Results There were statistically significant differences between AAC group and non-ACC group in age,diastolic blood pressure,mean arterial pressure,uric acid,proportion of cardio-cerebrovascular diseases,total parathyroid hormone and alkaline phosphatase(P<0.05).Compared with patients with non-2DM end-stage renal disease,the blood potassium of patients with 2DM was lower,but the difference was not statistically significant(P>0.05).Compared with non-2DM patients with end-stage renal disease,the AAC score level and the proportion of AAC score>0 and AAC score>5 in 2DM patients increased significantly(P<0.05).Age was associated with AAC in patients with 2DM end-stage renal disease(P<0.05).Age,sex,blood potassium,alkaline phosphatase,parathyroid hormone and cerebrovascular disease were associated with AAC in patients with non-2DM end-stage renal disease(P<0.05).Logistic regression model analysis showed that low blood potassium level was a risk factor for AAC score>5.The ROC curve analysis results showed that the area under curve of AAC score>5 in patients with 2DM end-stage renal disease diagnosed by blood potassium was 0.711,95%confidence interval

关 键 词：血钾 腹主动脉钙化 2型糖尿病 终末期肾病 

分 类 号：R692.5[医药卫生—泌尿科学]