慢性肾衰竭患者并发心血管疾病相关危险因素分析  

Related risk factors affecting cardiovascular diseases in patients with chronic renal failure

作　　者：姚律 黄小抗 朱琼[1] YAO Lv;HUANG Xiaokang;ZHU Qiong(Department of Nephrology,Anqing Medical Center,Anhui Medical University,Anqing 246003,China)

机构地区：[1]安徽医科大学安庆医学中心肾内科,安徽安庆246003

出　　处：《陕西医学杂志》2024年第1期55-58,63,共5页Shaanxi Medical Journal

基　　金：安徽省高校自然科学研究项目(2022AH04032)。

摘　　要：目的:探究慢性肾衰竭(CRF)患者并发心血管疾病(CVD)的相关危险因素。方法:选取111例CRF维持性血液透析患者作为研究对象,调查CVD发生情况。将其分为CVD组(n=54)、非CVD组(n=57),收集两组一般临床资料,采用Logistic单因素和多因素回归分析,探究CRF患者并发CVD的独立危险因素。结果:两组患者年龄、性别、体重指数(BMI)、合并糖尿病情况、心血管疾病史及原发病差异比较无统计学意义(均P>0.05);CVD组血红蛋白、Klotho蛋白水平均低于非CVD组(均P<0.05),低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)、血清磷酸盐、甲状旁腺激素(PTH)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)、硫酸对甲酚水平均高于非CVD组(均P<0.05);Logistic多因素回归分析显示,血红蛋白、Klotho蛋白下降及TG/HDL-C、IL-6、硫酸对甲酚升高均为CRF连续性血液透析患者发生CVD的独立危险因素(均P<0.05)。结论:血红蛋白和Klotho蛋白的下降以及TG/HDL-C、IL-6和硫酸对甲酚的升高均可增加CRF维持性血液透析患者CVD的风险,血液透析治疗期间应加强对上述危险因素的评估和管理。Objective:To analyze the related risk factors of cardiovascular diseases(CVD)in patients with chronic renal failure(CRF).Methods:A total of 111 patients with CRF undergoing maintenance hemodialysiswere selected as research subjects.The incidence of CVD was investigated,and the patients were divided into CVD group(n=54)and non-CVD group(n=57).General clinical data of the two groups were collected,and Logistic univariate and multivariate regression analyses were performed to explore the independent risk factors of CVD in patients with CRF.Results:There were no statistically significant differences in age,gender,Body Mass Index(BMI),diabetes mellitus,cardiovascular disease history and primary disease between the two groups(all P>0.05).The levels of hemoglobin and Klotho protein in CVD group were lower than those in non-CVD group(all P<0.05),while the levels of low density lipoprotein cholesterol(LDL-C),triglyceride(TG)/high density lipoprotein cholesterol(HDL-C),serum phosphate,parathyroid hormone(PTH),interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9)and p-cresol sulfate were higher than those in non-CVD group(all P<0.05).Logistic multivariate regression analysis showed that the decreases of hemoglobin and Klotho protein and the increases of TG/HDL-C,IL-6 and p-cresol sulfate were independent risk factors of CVD in patients with CRF undergoing maintenance hemodialysis(all P<0.05).Conclusion:The decreases of hemoglobin and Klotho protein and the increases of TG/HDL-C,IL-6 and p-cresol sulfate can increase the risk of CVD in patients with CRF undergoing maintenance hemodialysis,and it is necessary to strengthen the evaluation and management of these risk factors during hemodialysis treatment.

关 键 词：慢性肾衰竭 心血管疾病 危险因素 KLOTHO蛋白 硫酸对甲酚 

分 类 号：R692.5[医药卫生—泌尿科学]