基于MIMIC-Ⅳ数据库分析血清铁蛋白与重症糖尿病肾病患者预后的关系  

Relationship between Serum Ferritin and Prognosis in Patients with Severe Diabetic Kidney Disease Based on MIMIC-Ⅳ Database

作　　者：邵紫欣 汪何[2] 莫伟[2] 姜开文[2] 王霜玲[2] 毕建璐[2] 倪伟智 SHAO Zixin;WANG He;MO Wei(Fifth Clinical Medical College,Guangzhou University of Chinese Medicine,Guangdong 510000,China)

机构地区：[1]广州中医药大学第五临床医学院,510000 [2]广东省第二中医院,广州510095

出　　处：《医学研究杂志》2024年第4期57-61,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81774212);广东省中医药局项目(20181026,20222010);广东省名老中医药专家(汪何)传承工作室建设项目;中医特色重点医院建设工程。

摘　　要：目的 探讨重症糖尿病肾病(diabetic kidney disease, DKD)患者的血清铁蛋白(serum ferritin, SF)与预后的关系。方法 回顾性分析MIMIC-Ⅳ数据库中重症DKD患者的临床资料。根据入院后60天的生存状况,将重症DKD患者分为生存组(n=87)和死亡组(n=659);根据入院后60天的SF水平,将重症DKD患者分为低SF组(SF≤333ng/ml,n=373)和高SF组(SF>333ng/ml,n=373)。采用Kaplan-Meier曲线比较不同SF水平重症DKD患者的生存率,并采用多因素COX回归分析评估重症DKD患者60天全因死亡的危险因素。结果 共纳入746例重症DKD患者,60天全因死亡率为11.6%。死亡组患者的年龄、白细胞计数、红细胞分布宽度、肌酐、血尿素氮、尿蛋白、SF、急性肾损伤、持续性肾脏替代治疗的值均高于生存组,而收缩压、舒张压、血红蛋白、转铁蛋白则低于生存组。Kaplan-Meier曲线分析结果显示,高SF组患者的60天生存率明显低于低SF组(χ2=12.163,P<0.001)。多因素COX回归分析结果显示,高SF(HR=1.0001,95%CI:1.0001~1.0002)为重症DKD患者60天全因死亡的独立危险因素(P<0.05)。结论 高SF水平是重症DKD患者60天全因死亡的独立危险因素。Objective To investigate the relationship between serum ferritin(SF)and prognosis in patients with severe diabetic kidney disease(DKD).Methods The clinical data of severe DKD patients in the MIMIC-Ⅳdatabase were analyzed retrospectively.According to the survival condition at 60days after admission,the patients with severe DKD were divided into survival group(n=87)and death group(n=659).According to the SF level at 60days after admission,the patients with severe DKD were divided into low SF group(SF≤333ng/ml,n=373)and high SF group(SF>333ng/ml,n=373).The Kaplan-Meier curve was used to compare the survival rates of severe DKD patients with different SF levels,and multivariate COX regression analysis was used to evaluate the risk factors for 60-day all-cause death in severe DKD patients.Results A total of 746 patients with severe DKD were included,and the 60-day all-cause mortality rate was 11.6%.The values of age,white blood cell count,red blood cell distribution width,creatinine,blood urea nitrogen,urine protein,SF,acute kidney injury,and continuous renal replacement therapy in the death group were higher than those in the survival group,while the systolic blood pressure,diastolic blood pressure,hemoglobin,and transferrin were lower than those in the survival group.Kaplan-Meier curve analysis showed that the 60-day survival rate of high SF group was significantly lower than that of low SF group(χ2=12.163,P<0.001).Multivariate COX regression analysis showed that high SF(HR=1.0001,95%CI:1.0001-1.0002)was an independent risk factor for 60-day all-cause death in patients with severe DKD(P<0.05).Conclusion High level of SF level is an independent risk factor for 60-day all-cause death in patients with severe DKD.

关 键 词：糖尿病肾病 血清铁蛋白 预后 MIMIC-Ⅳ数据库 

分 类 号：R587[医药卫生—内分泌]