血镁与维持性血液透析患者心血管事件及全因死亡的相关性分析  

Correlation analysis of blood magnesium with cardiovascular events and all-cause death in hemodialysis patients

作　　者：沈裕欣 张倩楠[1] 夏洪 于颖吉 李军辉[1] SHEN Yuxin;ZHANG Qiannan;XIA Hong;YU Yingji;LI Junhui(Department of Nephrology,Putuo People's Hospital,Tongji University,Shanghai 200060,China)

机构地区：[1]同济大学附属普陀人民医院肾内科,上海200060

出　　处：《世界临床药物》2024年第9期943-949,共7页World Clinical Drug

基　　金：上海市普陀区卫生健康系统科技创新项目(Ptwws202412);上海市普陀区卫生管理类研究项目(2023PTGL13)。

摘　　要：目的 探讨维持性血液透析(maintenance hemodialysis,MHD)患者血镁水平与心血管事件、全因死亡的相关性。方法 回顾性分析2021年1月至2023年1月于我院接受MHD治疗的122例患者的临床资料,根据血镁中位水平将其分为高镁组(血镁≥0.93 mmol/L)(n=67)和低镁组(血镁<0.93 mmol/L)(n=55)。以Kaplan-Meier生存曲线比较两组累积生存率,以Cox回归模型分析全因死亡的危险因素。结果 两组血清白蛋白、前白蛋白、血镁、血磷、C反应蛋白等水平差异显著(P<0.05)。低镁组心血管事件发生率、全因死亡率均高于高镁组(P<0.05)。低镁组累积生存率显著低于高镁组(P<0.01)。单因素Cox回归模型分析示,低血镁是心血管事件及全因死亡的危险因素(P<0.01);多因素校正后,提示低血镁是心血管事件的独立危险因素(P<0.01),而并非全因死亡率的独立危险因素(P>0.05)。结论 MHD患者血镁水平偏低时心血管事件发生率更高,全因死亡风险增加。Objective To explore the correlation between blood magnesium level in patients with maintenance hemodialysis(MHD)and cardiovascular events and all-cause death.Methods The clinical data of 122 patients treated with MHD in our hospital from January 2021 to January 2023 were retrospectively analyzed,and the patients were divided into high magnesium group(blood magnesium≥0.93 mmol/L,n=67)and low magnesium group(blood magnesium<0.93 mmol/L,n=55)according to the median blood magnesium level.Kaplan-Meier survival curve was used to compare the cumulative survival rate of the two groups,and Cox regression model was used to analyze the risk factors of allcause death.Results The levels of serum albumin,prealbumin,magnesium,phosphorus and C-reactive protein were significantly different between the two groups(P<0.05).The incidence of cardiovascular events and all-cause mortality in low magnesium group were higher than those in high magnesium group(P<0.05).The cumulative survival rate of low magnesium group was significantly lower than that of high magnesium group(P<0.01).Univariate Cox regression analysis showed that hypomagnesium was a risk factor for cardiovascular events and all-cause death(P<0.01).After multifactor correction,hypomagnesium was an independent risk factor for cardiovascular events,but not an independent risk factor for all-cause death(P>0.05).Conclusion MHD patients with low blood magnesium levels have a higher incidence of cardiovascular events and an increased risk of all-cause death.

关 键 词：血镁 维持性血液透析 心血管事件 全因死亡 

分 类 号：R692[医药卫生—泌尿科学]