血液透析患者血清钠和镁与主要不良心血管事件的相关性分析  

作　　者：徐盼 陆晓艳[1] 朱淑盟 周建芳[1] 

机构地区：[1]浙江省杭州市中医院,310007

出　　处：《浙江临床医学》2025年第2期256-258,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨维持性血液透析(MHD)患者血清钠和镁浓度与主要不良心血管事件(MACE)的相关性。方法选取2022年1月至2022年6月在本院进行MHD治疗的376例患者,随访至2023年6月。收集患者一般资料、透析前血压、透析间期体质量增加值及相关血液指标,并计算平均值。统计患者一年内MACE发生次数,并根据MACE发生与否分组,比较MACE发生组与未发生组患者一般资料、透析前血压、透析间期体质量增加值及相关血液指标。以是否发生MACE为因变量,选取单因素分析中差异有统计学意义的变量(年龄、原发病、血清镁离子浓度、空腹血糖、血清钠离子浓度、高敏C反应蛋白、血清白蛋白)进行Logistics多因素回归分析。结果376例患者中有86例发生MACE,占22.87%。多因素分析显示,年龄、血清钠离子浓度、镁离子浓度是MHD患者发生主要不良心血管事件的独立影响因素(P<0.05)。结论低钠血症、低镁血症及高龄是MHD患者并发MACE的危险因素。临床上应重视患者血清钠和镁离子浓度的监测,保持其在适宜水平,并制定精准医疗和护理干预措施,以改善患者预后和提高生活质量。Objective To explore the correlation between serum sodium and magnesium concentrations and major adverse cardiovascular events(MACE)in patients undergoing maintenance hemodialysis(MHD).Methods A total of 376 patients who underwent MHD treatment at our hospital from January 2022 to June 2022 were selected and followed up until June 2023.General information of the patients,blood pressure before dialysis,weight gain during the interdialytic period,and related indicators were collected and their average values were calculated.The number of MACE occurrences within one year was statistically analyzed.Patients were grouped based on the occurrence of MACE,and their general information,blood pressure before dialysis,weight gain during the interdialytic period,and related indicators were compared.Logistic multifactorial regression analysis was conducted with variables that were statistically significant in the univariate analysis(age,primary disease,serum magnesium concentration,fasting blood glucose,serum sodium concentration,highsensitivity C-reactive protein,serum albumin)as the independent variables and the occurrence of MACE as the dependent variable.Results Among the 376 patients,86 experienced MACE,accounting for 22.87%.Multivariate analysis revealed that age,serum sodium concentration,and magnesium concentration were independent influencing factors for the occurrence of cardiovascular events in MHD patients(P<0.05).Conclusion Hyponatremia,hypomagnesem ia,and advanced age are risk factors for the occurrence of MACE in MHD patients.Clinically,it is important to monitor the serum sodium and magnesium concentrations of patients to maintain appropriate levels,and develop precise medical and nursing intervention measures to improve patient prognosis and quality of life.

关 键 词：维持性血液透析 低钠血症 低镁血症 主要不良心血管事件 

分 类 号：R692.5[医药卫生—泌尿科学]