应用腰椎侧位片评价血液透析患者腹主动脉钙化

目的 应用X线平片腹主动脉钙化评分探讨维持性血液透析( MHD)患者腹主动脉钙化患病率和相关危险因素分析.方法 选取我院资料完整的155例MHD患者为研究对象.通过X线腰椎侧位片检测腹主动脉钙化( AAC)并对其进行评分.结果 155例的腰椎侧位片中,腹主动脉钙化主要发生在第4腰椎节段,并随着节段的上升而逐渐减少.63.63％患者的侧位平片上可见腹主动脉钙化；28.39％患者可见严重腹主动脉钙化(钙化累及3个节段以上).MHD患者的年龄(OR=1.094,P＜0.01)、透析龄(OR=1.013,P=0.022)、血三酰甘油(OR=1.261,P=0.030)和血磷(OR=1.324,P=0.023)水平是发生腹主动脉钙化的独立危险因素,而白蛋白(OR=0.239,P=0.013)为保护性因素.结论 MHD患者腹主动脉钙化患病率高,且与多个血管钙化因素相关.半定量的X线腰椎侧位片方法价格便宜、操作简便,易于临床推广.其对MHD患者的预测价值有待日后更多的随访研究.

Abdominal aortic calcification detected by lateral lumbar X-ray in maintenance hemodialysis patients

Objective To explore the incidence and associated factors of aortic artery calcification (AAC) by lateral lumbar X-ray score in maintenance hemodialysis (MHD) patients. Mehtods A total of 155 MHD patients with complete clinical data in our hospital were enrolled in the study. Lateral lumbar X-ray score of the abdominal aorta was used to determine AAC in MHD patients. Results Aortic calcification was most severe in front of the fourth lumbar segment and ameliorated in higher lumbar levels. 63.63% of MHD patients presented visible calcification in the abdominal aorta, and 28.39% had severe calcification with more than three segments. Age (OR=1.094, P<0.01), dialysis vintage (OR=1.013, P=0.022), triglyceride (OR=1.261, P=0.030) and phosphate level (OR=1.324, P=0.023) were risk factors of abdominal aorta calcification, however serum albumin level (OR=0.239, P=0.013) was protect factor of aortic calcification. Conclusions Incidence of AAC is quite high in MHD patients and associated with increasing of age, duration of hemodialysis, serum triglyceride, phosphate level and plasma albumin. The semi-quantitative X-ray method of determining vascular calcification is less expensive and may be widely available clinically.