可溶性CD146水平对维持性腹膜透析患者预后的评估价值  

Evaluation Value of Soluble CD146 Levels in Patients with Maintenance Peritoneal Dialysis

作　　者：徐雯雯 窦艳娜[1,2] 王佩佩 李炎生 朱礼阳[1,2] 刘栋 XU Wenwen;DOU Yanna;WANG Peipei;LI Yansheng;ZHU Liyang;LIU Dong(Department of Nephrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Nephrology Institute of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肾脏内科,河南郑州450052 [2]郑州大学肾脏病研究所,河南郑州450052

出　　处：《河南医学研究》2023年第7期1163-1168,共6页Henan Medical Research

基　　金：国家自然科学基金(U1404804);河南省科技攻关项目(22170168)。

摘　　要：目的研究可溶性CD146(sCD146)水平对维持性腹膜透析患者预后的评估价值。方法纳入2018年12月至2019年6月在郑州大学第一附属医院肾内科住院的50例腹膜透析患者,其中4例失访,2例资料不全,最终共纳入44例。收集患者的血常规、血生化等实验室数据并测量其sCD146水平,以新发或者加重的心力衰竭、缺血性心肌病、心律失常、脑血管意外、死亡等作为复合终点事件,观察腹膜透析患者的预后情况。结果对患者随访24个月,腹膜透析患者中27例继续腹膜透析,10例转为血液透析,4例肾移植,3例死亡;18例发生不良事件,包括死亡3例,心力衰竭11例,急性脑梗死2例,不稳定型心绞痛2例。对患者随访过程中出现的不良事件进行Cox回归分析,多因素Cox回归分析显示sCD146和体重指数(BMI)是发生不良事件的独立危险因素(P<0.05)。将腹膜透析患者按sCD146水平的中位数分成高浓度组和低浓度组,Kaplan-Meier生存曲线显示两组无不良事件生存率差异无统计学意义(P>0.05)。结论sCD146浓度是腹膜透析患者发生心脑血管不良事件的独立危险因素,sCD146可能作为评估腹膜透析患者预后的相关指标。注重透析患者容量管理可减少心脑血管不良事件的发生,提高无不良事件生存率。Objective To study the prognostic value of soluble CD146(sCD146)level in maintenance peritoneal dialysis patients.Methods A total of 50 peritoneal dialysis patients hospitalized in the Department of Nephrology,the First Affiliated Hospital of Zhengzhou University from December 2018 to June 2019 were included,of which 4 patients were lost to follow-up and 2 patients had incomplete information.Finally,44 patients were included.The laboratory data of blood routine and blood biochemistry were collected and the sCD146 level was measured.The new or aggravated heart failure,ischemic cardiomyopathy,arrhythmia,cerebrovascular accident,and death were taken as the composite endpoints to observe the prognosis of peritoneal dialysis patients.Results The patients were followed up for 24 months.Among the peritoneal dialysis patients,27 cases continued peritoneal dialysis,10 cases were converted to hemodialysis,4 cases underwent kidney transplantation,3 cases died,and 18 cases had adverse events,including 3 deaths,11 cases of heart failure,2 cases of acute cerebral infarction and 2 cases of unstable angina pectoris.COX regression analysis was used to analyze the adverse events during the follow-up of patients.Multivariate Cox regression analysis showed that sCD146 and body mass index(BMI)were independent risk factors for adverse events(P<0.05).Peritoneal dialysis patients were divided into a high-concentration group and a low-concentration group according to the median level of sCD146.Kaplan-Meier survival curve showed that there was no statistical difference in adverse event-free survival rate between the two groups(P>0.05).Conclusion The concentration of sCD146 is an independent risk factor for cardiovascular and cerebrovascular adverse events in peritoneal dialysis patients,and sCD146 may be used as a related index to evaluate the prognosis of peritoneal dialysis patients.Paying attention to the volume management of dialysis patients can reduce the occurrence of cardiovascular and cerebrovascular adverse events and improve th

关 键 词：可溶性CD146 维持性腹膜透析 心脑血管事件 预后 

分 类 号：R459.5[医药卫生—治疗学]