基于CHARLS数据库肌酐水平与心脏病患者死亡的相关性分析  

Empirical analysis of the correlation between creatinine and death in patients with heart disease based on CHARLS database

作　　者：郭卫华 杨滨[1] 雷永兰[2] 李靖 GUO Weihua;YANG Bin;LEI Yonglan;LI Jing(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Department of Clinical Laboratory,Panzhihua Central Hospital,Panzhihua,Sichuan 617067,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041 [2]攀枝花市中心医院检验科,四川攀枝花617067

出　　处：《国际检验医学杂志》2024年第7期853-857,共5页International Journal of Laboratory Medicine

摘　　要：目的基于中国健康与养老追踪调查(CHARLS)大型社区研究数据库,探究中国中老年人群肌酐水平预期心脏病发生死亡的相关性。方法收集CHARLS数据库中心脏病患者的2011年血液学检查结果及2018年生存情况数据,将患者按2018年生存情况分为死亡组和存活组,共纳入死亡组133例,存活组982例。比较两组一般人口学、血液学检查结果、疾病史的差异,并通过线性回归方法分析与心脏病死亡有关的因素。结果与存活组相比,死亡组的平均年龄更高、男性比例更多,差异有统计学意义(P<0.05);与存活组相比,死亡组心脏病有关的风险指标(如慢性肺部疾病、胃部疾病或消化系统疾病)患者比例更高(P<0.05),死亡组有哮喘、吸烟史的比例更高(P<0.05)。两组在有无高血压、血脂异常、糖尿病或血糖升高、肝脏疾病、卒中、情感及精神方面问题、与记忆相关的疾病、关节炎或风湿病方面比较,差异无统计学意义(P>0.05)。血液学检查结果显示,两组肌酐、血小板计数、尿素氮、血糖、C反应蛋白、尿酸、血红蛋白水平比较,差异有统计学意义(P<0.05);而白细胞计数、平均红细胞体积、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、糖化血红蛋白、红细胞比容比较,差异无统计学意义(P>0.05)。多因素Logistic线性回归分析结果显示,除胃部疾病或消化系统疾病、哮喘、吸烟史、血糖、C反应蛋白、年龄是心脏病患者死亡的高风险因素外,2011年心脏病患者的肌酐水平和长期死亡风险增加有关[比值比(OR)=3.068,95%CI:1.193~7.894,P=0.020]。结论高肌酐水平可能预示着心脏病患者死亡风险增加,胃部疾病或消化系统疾病、哮喘、吸烟史、血糖、肌酐、C反应蛋白、年龄可能是中老年心脏病患者长期死亡风险的危险因素。Objective To explore the association of creatinine levels with expected death from heart disease in middle-aged and elderly Chinese population based on a large community study database of CHARLS.Methods Hematological examination results of heart disease patients in 2011 and survival data in 2018 were collected in the database,and the patients were divided into death group and survival group according to their survival in 2018.A total of 133 patients were included in the death group and 982 in the survival group.Differences in general demographics,hematological findings,and disease history were compared between the two groups,and factors associated with death from heart disease were analyzed by linear regression.Results Compared with the survival group,the average age of the death group was higher and the proportion of males was more(P<0.05).Compared with the survival group,the death group had more patients with risk indicators related to heart disease,such as chronic lung disease,stomach disease,or digestive disease(P<0.05),and the death group had a higher proportion of asthma and smoking history(P<0.05).There was no significant difference between the two groups in hypertension,dyslipidemia,diabetes or elevated blood glucose,liver disease,stroke,emotional and mental problems,memory related diseases,arthritis or rheumatism(P>0.05).The results of hematology examination showed that the levels of creatinine,platelet count,urea nitrogen,blood glucose,C-reactive protein,uric acid and hemoglobin were significantly different between the two groups(P<0.05).There was no significant difference in white blood cell count,mean red blood cell volume,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,glycated hemoglobin and hematocrit(P>0.05).The results of multivariate logistic linear regression analysis showed that in addition to stomach or digestive diseases,asthma,smoking history,blood glucose,C-reactive protein,and age as risk factors for death in patients with heart disease,creatinine levels in

关 键 词：肌酐 心脏病 死亡 危险因素 

分 类 号：R541[医药卫生—心血管疾病]