血液透析患者心血管标志物水平变化与其预后的相关性研究
Correlation study of cardiovascular markers on prognosis of maintenance hemodialysis patients

宋家志.血液透析患者心血管标志物水平变化与其预后的相关性研究[J].内科急危重症杂志,2017,23(5):

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英文关键词:Hemodialysis Cardiovascular markers Cardiovascular disease

基金项目:四川省卫生厅科研课题（120067）

作者	单位	E-mail
宋家志	四川省成都市第五人民人民医院重症医学科	19861124song@sina.com

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中文摘要:

目的：探讨血液透析（MHD）患者的各项心血管标志物水平变化与其预后的相关性。方法：选取我院284名符合要求的MHD患者，根据随访结果分为非死亡组，心血管死亡组和其他原因死亡组，对患者血中的一系列心血管标志物进行单因素分析和多因素回归分析，利用ROC曲线分别对非死亡组和心血管死亡组、非死亡组和其他原因死亡组的心血管标志物进行预测效能对比分析。结果：单因素和多因素结合分析表明，血磷、同型半胱氨酸、甘油三酯、氨基末端脑钠肽前体、高敏C反应蛋白、肌钙蛋白、纤维蛋白原为独立危险因素（P<0.05）；ROC曲线分析显示，心血管死亡组与非死亡组相比，纤维蛋白原、血磷、高敏C反应蛋白和肌钙蛋白这四项指标的曲线下面积大于0.8；心血管死亡组与其他原因死亡组相比，纤维蛋白原、氨基末端脑钠肽前体和血磷的曲线下面积大于0.8，两组曲线都显示了纤维蛋白原和血磷有较大的曲线下面积。结论：临床上可以从心血管标志物的检查中发现MHD患者心血管的早期病变（CVD），并预测患者的预后。

英文摘要:

Objective:To evaluate the correlation between cardiovascular markers and the prognosis of hemodialysis patients. Methods: The clinical data at baseline in 284 MHD patients were involved. Patients were divided into three groups, including the non-death group, cardiovascular death group and the other cause death group. Single factor analysis and multi-factor logistic regression analysis were used to analysis patients’ basic information and a series of cardiovascular markers. ROC curves were used to analysis the predictive cardiovascular markers between the non-death group and the cardiovascular death group, also between the non-death group and the other cause death group. Results: P, Hcy, TG, NT-proBNP, CRP, TnT and Fib showed that they were independent risk factors through single factor analysis and multi-factor logistic regression analysis. ROC curves showed that Fib, P, CRP and TnT whose AUC were larger than 0.8 in the contrast between the non-death group and the cardiovascular death group. Also, it showed that Fib, NT-proBNP and P whose AUC were larger than 0.8 in the contrast between the cardiovascular death group and the other cause death group. Both of ROC curves claimed that Fib and P have larger AUC than others. Conclusions: Early stage CVD will be found through cardiovascular markers examine for HD patients. Furthermore, the prognosis of HD patients will be predicted through the same way.