血清Serpin B1水平对终末期肾病新入血液透析患者发生心血管事件有预测价值

张健美.血清Serpin B1水平对终末期肾病新入血液透析患者发生心血管事件有预测价值[J].内科急危重症杂志,2024,30(3):247-250

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DOI：10.11768/nkjwzzzz20240311

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基金项目:秦皇岛市科学技术研究与发展计划（202004A101）

作者	单位
张健美	秦皇岛市第一医院

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中文摘要:

摘要目的：探讨血清丝氨酸蛋白酶抑制剂B1（Serpin B1）水平与终末期肾病新入血液透析患者发生心血管事件关联性。方法：回顾性分析160例终末期肾病患者的临床资料，根据患者治疗期间是否发生心血管事件将患者分为发生组（94例）与未发生组（66例）。比较2组患者一般资料（性别、年龄、合并症等）、血生化指标（总胆固醇、血红蛋白、甘油三酯等）。采用单因素分析终末期肾病新入血液透析患者发生心血管事件发生的影响因素，并将有统计学意义的项目纳入多因素Logistic回归，分析终末期肾病血液透析患者发生心血管事件的危险因素。采用受试者工作特征（ROC）曲线分析血清Serpin B1水平对终末期肾病新入血液透析患者发生心血管事件的预测价值。结果：2组患者年龄、甘油三酯、肌钙蛋白、C反应蛋白、血肌酐、甲状旁腺激素及Serpin B1比较，差异有统计学意义（P均＜0.05）。进一步进行Logistic回归分析，结果显示年龄（OR=2.34,95%CI：1.11~4.93）、C反应蛋白（OR=3.57,95%CI：2.22~5.76）、肌钙蛋白（OR=7.19,95%CI：3.15~16.37）及血清Serpin B1（OR=14.94，95%CI：2.69~82.85）是终末期肾病新入血液透析患者发生心血管事件的危险因素（P均＜0.05）。ROC曲线分析表明血清Serpin B1具有较高的预测价值，其最佳截断值为70.34ng/mL，曲线下面积（AUC）为0.879（95%CI：0.84~0.92），其敏感度与特异性分别为79.89%与76.65%。结论：终末期肾病新入血液透析发生心血管事件患者血清Serpin B1水平较高，血清Serpin B1水平对于预测此类患者发生心血管事件提供一定参考价值。

英文摘要:

Abstract Objective: To investigate the relationship between serum Serpin B1 level and cardiovascular events in patients with end-stage renal disease (ESRD) undergoing initial hemodialysis. Methods: The clinical data of 160 patients with end-stage renal disease were analyzed retrospectively. According to the occurrence of cardiovascular events during treatment, the patients were divided into two groups: occurrence group (n= 94) and non-occurrence group (n= 66). The general data (sex, age, complications, etc.) and blood biochemical indexes (total cholesterol, hemoglobin, triglyceride, etc.) were compared between the two groups. Univariate analysis was used to analyze the influencing factors of cardiovascular events in patients with end-stage renal disease undergoing initial hemodialysis, and statistically significant items were included in multivariate Logistic regression to analyze the risk factors of cardiovascular events in patients with end-stage renal disease undergoing hemodialysis. The receiver operating characteristic (ROC) curve was used to analyze the value of serum Serpin B1 level in predicting cardiovascular events in patients with end-stage renal disease undergoing initial hemodialysis. Results: There were significant differences in age, triglyceride, troponin, C-reactive protein, serum creatinine, parathyroid hormone and Serpin B1 between the two groups (all P< 0.05). Further Logistic regression analysis showed that age (OR= 2.34, 95% CI: 1.11-4.93), C-reactive protein (OR= 3.57, 95% CI: 2.22-5.76), troponin (OR=7.19, 95% CI: 3.15-16.37) and serum Serpin B1 (OR= 14.94, 95% CI: 2.69-82.85) were risk factors for cardiovascular events in patients with end-stage renal disease undergoing initial hemodialysis (all P< 0.05). The ROC curve analysis showed that serum Serpin B1 had high predictive value, the best cut-off value was 70.34ng/mL, the area under the curve (AUC) was 0.879 (95% C1: 0.84-0.92), and its sensitivity and specificity were 79.89% and 76.65%, respectively. Conclusion: The level of serum Serpin B1 in patients with cardiovascular events in patients with end-stage renal disease undergoing initial hemodialysis is higher, and the level of serum Serpin B1 provides a certain reference value for predicting cardiovascular events in these patients.