慢性肾脏病患者发生心脏瓣膜钙化的危险因素

目的观察慢性肾脏病患者心脏瓣膜钙化(CVC)的发生率并分析其危险因素。方法收集2009-09-2011-12在我科住院的慢性肾脏病患者258例,均采用德国西门子ACUSONCV70型彩色多普勒超声仪检测患者CVC情况,并将患者分为CVC组与无CVC组,比较两组临床有关参数的变化,探讨钙化相关危险因素。结果慢性肾脏病患者CVC的检出率为25.2%(65/258),并且随着年龄增长,慢性肾脏病患者CVC的检出率逐渐增加(P<0.05),男性患者CVC的发生率较女性患者明显升高(P<0.05)。与无CVC组相比,CVC组年龄、男性比例、高敏C反应蛋白(hsCRP)明显增高,而舒张压、高密度脂蛋白胆固醇(HDL-C)、血浆白蛋白明显降低。CVC组虽然血钙、血磷、钙磷乘积、甲状旁腺激素(PTH)与无CVC组差异无统计学意义,但前者应用药物纠正钙磷紊乱的比例明显高于无CVC组。多因素分析显示年龄增大、hsCRP升高和低白蛋白血症是CVC的危险因素,高HDL-C是CVC的保护因素。结论慢性肾脏病患者CVC的发生与年龄、性别、血压、微炎症状态和营养不良有关。

Risk fators of cardiac valve calcification in patients with chronic kidney disease

Objective To observe the occurence of cardiac valve calcification ( CVC ) in patients with chronic kidney disease ( CKD ) and to analyze the related risk factors. Methods The color doppler ultrasonography was performed on 258CKD patients which were collected in our department from September 2009to December 2011. The patients were divided into two groups : CVC group and no CVC group. The clinical datas were compared and the related risk factors of calcification were investigated. Results It was showed that prevalence of CVC in CKD patients was 25.2% ( 65 / 258 ) and it significantly increased with age ( P<0.05 ), and males had a higher rate of incidence than females ( P<0.05 ) . Those with older age,higher high-sensitivity C-reactive protein ( hsCRP ), and lower diastolic blood pressure,high density lipoprotein cholesterol ( HDL-C ) and serum albumin had a higher risk to suffer CVC. Although there were no differences between the two groups on plasma parathymid hormone level,calcium,phosphate,it was shown that patients using calcium supplement and vitamin D had a higher incidence of CVC. Multivariate analysis showed that the older,high level of hsCRP and hypoalbuminemia were risk factors of CVC,high level of HDL-C was protective factor of CVC. Conclusion Aging,gender,hypertension,malnutrition and inflamation are associated with cardiac CVC in patients with CKD.