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目的了解维持性血液透析患者中代谢综合征(MS)的发生情况,并分析相关危险因素。方法收集202例接受维持性血液透析患者的临床资料。根据国际糖尿病联盟MS诊断标准,将患者分为MS组和非MS组,计算MS的发病率;比较两组患者的体格测量数据、实验室指标、透析处方及心血管事件发生情况。对与MS发生可能相关的危险因素进行多因素Logistic回归分析。结果 202例患者中MS发病率为29.2%。两组患者以下指标比较差异均有统计学意义(P<0.05),包括体质量、腰围、体质量指数、血清谷丙转氨酶、胆固醇、三酰甘油、低密度脂蛋白、高密度脂蛋白、空腹血糖、C反应蛋白(CRP)和全段甲状旁腺激素水平(iPTH),尿素下降率、尿素清除指数及透析频率和每周透析时间。MS组与非MS组心血管事件发生率(25.4%vs18.2%)比较差异无统计学意义(P>0.05)。多因素Logistic回归分析表明,体质量(优势比OR=24.625)、女性(OR=8.000)、CRP(OR=4.700)、iPTH(OR=2.525)与MS的发生相关。结论 MS在维持性血液透析患者中并不少见,女性、肥胖、高iPTH和高CRP是MS发生的危险因素。
Objective To understand the occurrence of metabolic syndrome (MS) in maintenance hemodialysis patients and to analyze the related risk factors. Methods The clinical data of 202 patients undergoing maintenance hemodialysis were collected. According to the diagnostic criteria of International Diabetes Federation MS, the patients were divided into MS group and non-MS group to calculate the incidence of MS. The physical measurement data, laboratory indexes, dialysis prescription and cardiovascular events were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the possible risk factors associated with MS. Results The incidence of MS in 202 patients was 29.2%. There were significant differences in the following indexes between the two groups (P <0.05), including body weight, waist circumference, body mass index, serum alanine aminotransferase, cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fasting Blood glucose, C-reactive protein (CRP) and total parathyroid hormone levels (iPTH), urea decline rate, urea clearance index and dialysis frequency and dialysis time per week. There was no significant difference in the incidence of cardiovascular events between MS group and non-MS group (25.4% vs 18.2%) (P> 0.05). Multivariate logistic regression analysis showed that body mass (odds ratio OR = 24.625), female (OR = 8.000), CRP (OR = 4.700) and iPTH (OR = 2.525) were associated with MS. Conclusion MS is not uncommon in patients with maintenance hemodialysis. Female, obesity, high iPTH and high CRP are risk factors for MS.