高甲状旁腺激素腹膜透析者颈动脉斑块发生率及其影响因素

目的 探讨高甲状旁腺激素腹膜透析者颈动脉斑块的发生率及影响因素.方法 根据甲状旁腺激素水平将受试者分为甲状旁腺激素正常组及甲状旁腺激素升高组.应用二维超声检测受试者颈动脉斑块,选用Logistic分析评估颈动脉斑块的危险因素.结果 共145例腹膜透析者纳入研究,其中甲状旁腺激素正常组69例（47.7％）,甲状旁腺激素升高组76例（39.1％）.与甲状旁腺激素正常组相比,甲状旁腺激素升高组颈动脉斑块发生率明显升高（50.3％ vs 30.5％,P＜0.001）.在甲状旁腺激素升高组,校正各种混杂因素后,高龄[比值比（OR）=1.04,95％可信区间（CI）1.02～ 1.06]、糖尿病（OR=3.31,95％ CI 1.92～6.43）、高血磷（OR=1.02,95％ CI 1.01 ～ 1.03）、高钙磷乘积（OR=1.27,95％ CI 1.10～4.54）为颈动脉斑块形成的独立危险因素.结论 高甲状旁腺激素的腹膜透析者颈动脉斑块发生率高,高龄、糖尿病、高血磷及高钙磷乘积是其动脉斑块形成的独立危险因素.

Prevalence and risk factors of carotid artery plaque in hyper-parathyroid hormone patients undergoing peritoneal dialysis

Objective To evaluate the prevalence and of risk factors of carotid artery plaque in hyper-parathyroid hormone patients undergoing peritoneal dialysis.Methods All the patients were assigned to the normal parathyroid hormone group （n =69） or the high parathyroid hormone group （n =76）.Ultrasonography was used to observe the carotid artery.Risk factors of carotid artery plaque were investigated by Logistic regression.Results One hundred and forty-five patients were recruited,including 69 （47.7 ％） in the normal parathyroid hormone group and 59 （39.1％） in the high parathyroid hormone group.The prevalence of carotid artery plaque in the high parathyroid hormone group was significantly higher than that of the normal parathyroid hormone group （50.3％ vs 30.5％,P ＜ 0.001）.Among those with higher parathyroid hormone,older age （odds ratio （OR） =1.04,95％ confidence interval （CI） 1.02-1.06）,diabetes mellitus （OR =3.31,95％ CI 1.92-6.43）,hyperphospheremia （OR =1.02,95％ CI 1.01-1.03） and high calcium phosphorus product （OR =1.27,95％ CI 1.10-4.54） were independentlyassociated with increased risk of carotid artery plaque.Conclusions Patients with hyper-parathyroid hormone may show higher prevalence of carotid artery plaque when compared with those with normal parathyroid hormone.Older age,diabetes mellitus,hyperphosphemmia and high calcium phosphorus product could be independently associated with increased risk of carotid artery plaque among those with hyperparathyroid hormone.