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目的:探讨维持性腹膜透析患者颈动脉钙化的相关危险因素。方法:入选绵阳市中心医院腹膜透析室稳定接受规律腹膜透析的患者100人,按照颈动脉是否钙化分为颈动脉钙化组(55例),颈动脉正常组(45例)。收集患者临床资料,评估残余肾功能和透析充分性,采用彩超检查评估颈动脉有无钙化。用二元logistics回归法分析颈动脉钙化的独立危险因素。结果:2组患者比较:颈动脉钙化组较颈动脉正常组年龄(42.36±8.79 vs.34.93±9.60)岁、空腹血糖(6.91±0.44 vs.6.66±0.30)mmol/L、钙磷乘积(3.98±0.40 vs.3.82±0.30)mmol/L、甲状旁腺激素(parathyroid hormone,PTH)(270.72±30.24 vs.260.23±11.05)ng/L增加(P<0.05),而残余肾功能(2.25±0.74 vs.5.14±1.07)m L/min、总肌酐清除率(creatinine clearance rate,Ccr)(59.92±3.94 vs.66.11±7.01)L/(周·1.73 m~2)、残余肾Ccr(19.66±2.85 vs.25.07±6.53)L/(周·1.73 m~2)、总尿素清除指数(urea clearance index,Kt/V)(4.06±0.51 vs.4.46±0.39)、残肾Kt/V(1.12±0.30 vs.1.45±0.28)较颈动脉正常组降低(P<0.05)。logistic回归分析显示:透析龄(OR=1.218,P=0.039)、钙磷乘积(OR=70.403,P=0.037)、残余肾功能(OR=0.030,P=0.001)、残肾Ccr(OR=0.692,P=0.015)是颈动脉钙化的影响因素。结论:行规律腹膜透析患者的颈动脉钙化发生率较高,透析龄长、高钙磷乘积和低残余肾功能是腹膜透析患者发生颈动脉钙化的独立危险因素。
Objective: To investigate the related risk factors of carotid artery calcification in maintenance peritoneal dialysis patients. Methods: A total of 100 patients undergoing regular peritoneal dialysis in the peritoneal dialysis room of Central Hospital of Mianyang were enrolled and divided into carotid artery calcification group (n = 55) and normal carotid artery group (n = 45) according to whether carotid artery calcification. The clinical data were collected to assess residual renal function and dialysis adequacy. Carotid artery calcification was assessed by color Doppler ultrasonography. Analysis of independent risk factors for carotid artery calcification by binary logistic regression. Results: The carotid artery calcification group was significantly longer than the normal carotid artery group (42.36 ± 8.79 vs.34.93 ± 9.60), fasting blood glucose (6.91 ± 0.44 vs 6.66 ± 0.30) mmol / L, calcium phosphate product ± 0.40 vs.3.82 ± 0.30) mmol / L, PTH (270.72 ± 30.24 vs.260.23 ± 11.05) ng / L increased (P <0.05), while residual renal function (2.25 ± 0.74 vs.5.14 ± 1.07) m L / min, creatinine clearance rate (Ccr) (59.92 ± 3.94 vs.66.11 ± 7.01) L / (week · 1.73 m -2), residual renal Ccr (19.66 ± 2.85 vs.25.07 ± 6.53) L / (week · 1.73 m 2), urea clearance index (Kt / V) (4.06 ± 0.51 vs.4.46 ± 0.39), residual kidney Kt / V vs.1.45 ± 0.28) than the normal carotid artery group (P <0.05). Logistic regression analysis showed that the residual renal function (OR = 0.030, P = 0.001), residual kidney Ccr (OR = 0.692 , P = 0.015) were the influencing factors of carotid artery calcification. Conclusion: Peritoneal dialysis patients with high incidence of carotid artery calcification, long dialysis age, high calcium-phosphorus product and low residual renal function are independent risk factors for carotid artery calcification in peritoneal dialysis patients.