老年维持性血液透析病人心脏瓣膜钙化的相关因素分析  

Analysis of related factors for cardiac valve calcification in elderly patients with maintenance hemodialysis

作　　者：田英[1] 丁弘[1] 曹婧媛 徐丽[1] 朱进华[1] TIAN Ying;DING Hong;CAO Jingyuan;XU Li;ZHU Jinhua(Department of Nephrology,Yangzhong People’s Hospital Affiliated to Medical College of Yangzhou University,Zhenjiang 212200,China;Yangzhou University School of Medicine,Yangzhou 225000,China)

机构地区：[1]扬中市人民医院肾内科,江苏省镇江市212200 [2]南京医科大学附属泰州人民医院肾内科,江苏省泰州市225300

出　　处：《实用老年医学》2024年第7期649-653,共5页Practical Geriatrics

基　　金：江苏省卫生健康委员会医学科研项目(M2021048);南京医科大学泰州临床医学院科研项目(TZKY20220209);江苏省中西医结合老年病防治中心重点实验室开放课题(202243);北京健康促进会中国血液透析血管通路青年医师研究项目。

摘　　要：目的 分析老年维持性血液透析(MHD)病人心脏瓣膜钙化(CVC)的相关因素。方法 选择2022年6—9月在扬中市人民医院血液净化中心治疗的104例老年MHD病人为研究对象,依据瓣膜钙化情况分为CVC组(45例)和非CVC组(59例),比较2组的基线资料、血管内皮功能、冠状动脉钙化程度以及心脏结构与功能。采用多因素Logistic回归分析老年MHD病人发生CVC的危险因素。结果 CVC组年龄、冠状动脉钙化总分、冠状动脉左主干和右冠状动脉钙化积分、舒张末左室后壁厚度、舒张末室间隔厚度、左心室质量指数均显著高于非CVC组,肱动脉血流介导的内皮依赖性舒张功能(FMD)明显小于非CVC组,差异有统计学意义;多因素Logistic回归显示:年龄增长(OR=1.121,95%CI:1.025~1.227)和FMD降低(OR=0.879,95%CI:0.791~0.978)是老年MHD病人发生CVC的危险因素(均P<0.05)。结论 年龄增长和FMD减退与老年MHD病人发生CVC相关,临床中通过检测FMD可能有助于早期识别、预警CVC的发生。Objective To analyze the influencing factors of cardiac valve calcification(CVC)in the elderly patients receiving maintenance hemodialysis(MHD).Methods A total of 104 elderly MHD patients treated at the Blood Purification Center of Yangzhong People’s Hospital from June to September 2022 were selected as the study subjects.Based on the presence of CVC,they were divided into CVC group(45 cases)and non-CVC group(59 cases).Baseline data,vascular endothelial function,coronary artery calcification scores,and cardiac structure and function were compared between the two groups.Logistic regression analysis was used to identify the risk factors for CVC in the elderly MHD patients.Results Age,total score of coronary artery calcification,left main coronary artery and right coronary artery calcification score,post-diastolic left ventricular wall thickness,post-diastolic ventricular septal thickness and left ventricular mass index in CVC group were significantly higher and brachial arterial flow-mediated dilatation(FMD)in CVC group was significantly lower than those in non-CVC group.Multivariate Logistic regression analysis showed that aging(OR=1.121,95%CI:1.025-1.227)and the level of FMD(OR=0.879,95%CI:0.791-0.978)were the related factors for CVC in the elderly MHD patients(All P<0.05).Conclusions Aging and the decline of FMD are risk factors for CVC in the elderly MHD patients.Detection of FMD may be helpful for early identification and early warning of CVC.

关 键 词：老年人 维持性血液透析 心脏瓣膜钙化 

分 类 号：R542.5[医药卫生—心血管疾病]