维持性血液透析患者短期内并发心脏事件的危险因素分析  

Risk Factors Analysis Study of Short-term Cardiovascular Event in Maintenance Hemodialysis Cohort

作　　者：夏世国 赵文娟 汪年松[3] 王秦[1] XIA Shiguo;ZHAO Wenjuan;WAN Niansong(Department of Nephrology&Rheumatology,South Hospital of Shanghai Sixth People’s Hospital,Shanghai,200003)

机构地区：[1]上海交通大学附属第六人民医院南院肾脏风湿科,上海200003 [2]上海交通大学附属第六人民医院南院老年科,上海200003 [3]上海交通大学附属第六人民医院肾脏科,上海200003

出　　处：《中国中西医结合肾病杂志》2024年第3期211-214,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市奉贤区科委基金资助项目(No.奉科20201503)。

摘　　要：目的:探讨维持性血液透析(MHD)患者透析中发生心脏事件的危险因素和预警指标。方法:选取2021年01月—2021年06月行MHD治疗的患者共计324例。收集相关临床资料,血液检测,心脏超声,生物电阻抗检测指标等。患者纳入观察之后30天内是否发生心脏事件,分析组间差异和危险因素。结果:53例患者发生心脏事件,单因素分析显示心脏事件组使用双腔导管更多,透析前收缩压更高,TBW,ECW/TBW,CRP,IL6,TNF-α,IL-8,IL-10,TC,TG,LDL-C,LVEDD,LVESD,高敏肌钙蛋白,NT-proBNP等指标也高于对照组,而Kt/V,白蛋白,血红蛋白低于对照组(P<0.05)。Logistic回归分析显示LVEDD,NT-proBNP,ECW/TBW和IL-8是发生心脏事件的危险因素。ROC曲线表明上述指标具有预测价值。结论:MHD患者发生心脏事件比例较高,LVEDD、NT-proBNP、ECW/TBW和IL-8是其危险因素,可作为预警指标用于风险分层管理。Objective:To explore the risk factors and warning indicators of cardiovascular events in the maintenance hemodialysis(MHD)cohort.Methods:A total of 324 patients who underwent MHD treatment from January 2021 to June 2021 were enrolled in this study.Data of relevant clinical data,blood tests,cardiac ultrasound,bioelectrical impedance testing,and other indicators were collected.After the inclusion of patients,the cohort was grouped based on whether there was any cardiovascular event within 30 days.Moreover,the differences and risk factors between the two groups were analyzed.Results:In the cohort,53 cases had cardiovascular events.Univariate analysis showed that the group that experienced cardiovascular events used more catheters,correlated with higher systolic blood pressure before dialysis,and higher TBW,ECW/TBW,CRP,IL6,TNF-α,IL-8,IL-10,TC,TG,LDL-C,LVEDD,LVESD,high-sensitivity troponin,and NT-proBNP,but lower KT/V,albumin,and hemoglobin levels(P<0.05).Logistic regression analysis showed that LVEDD,NT-proBNP,ECW/TBW,and IL-8 were risk factors for cardiovascular events.ROC curves showed that LVEDD,NT-proBNP,ECW/TBW,and IL-8 had predictive values for cardiovascular events.Conclusion:The proportion of cardiovascular events in MHD patients was high.LVEDD,NT-proBNP,ECW/TBW,and IL-8 were the risk factors of cardiovascular events in this MHD cohort,and those indicators may be utilized in the risk stratification management of MHD patients.

关 键 词：维持性血液透析 心脏事件 心功能 脑钠肽 生物电阻抗 

分 类 号：R692.5[医药卫生—泌尿科学] R54[医药卫生—外科学]