糖尿病与非糖尿病腹膜透析患者新发心血管事件及危险因素分析

目的探讨糖尿病与非糖尿病腹膜透析（peritoneal dialysis，PD）患者新发心血管事件（cardiovascular disease，CVD）发生的特点．并了解影响患者CVD发生的主要危险因素。方法通过回顾128例维持性PD患者的临床资料，比较43例糖尿病和85例非糖尿病PD患者新发CVD的异同，logistic回归分析影响患者CVD发生的主要危险因素。结果糖尿病PD患者在随访期闰共发生62次新发CVD，显著高于非糖尿病患者的39次（P〈0．01）。糖尿病PD患者在新发脑梗死、缺血性心脏病、充血性心功能衰竭的发生率显著高于非糖尿病患者（P〈0．05），其中糖尿病PD患者中脑梗死的发生率升高尤为明显。年龄、性别、糖尿病以及感染为影响本研究患者新发CVD发生的主要危险原因（P〈0．01）。结论与非糖尿病患者相比，糖尿病PD患者具有更高的新发CVD发生率，其新发脑梗塞风险的升高尤为明显。除糖尿病外，患者的年龄、性别、糖尿病以及感染也是透析后新发CVD的重要危险因素。

Comparison of new-onset cardiovascular disease between diabetes mellitus and non-diabetes mellitus patients in peritoneal dialysis and investigation of risk factors for its incidence

Objective To investigate the character of new-onset cardiovascular disease （CVD） in peritoneal dialysis（PD） patients with diabetes mellitus（DM） and without DM（non-DM）,and to determine the risk factors for its incidence. Methods 128 PD patients were included in this retrospective study. Baseline demographic, clinical, biochemical, dialysis data and the attacks of new-onset cardiovascular disease were collected for comparison between DM and non-DM patients. The risk factors that may affect the attacks of new-onset cardiovascular disease were also evaluated by the method of multivariate logistic regression analysis in this study. Results 62 attacks of new-onset CVD in PD patients with DM were significantly more than 39 attacks in PD patients without DM（ P 〈0.01）. The morbidity rates of cerebral infarction,ischemic heart disease and congestive heart failure in DM patients were significantly higher than that in non-DM patients（ P 〈0.05）. And evident increased rate of cerebral infarction attacks was more significant in DM patients. Age, sex,DM and infection were the main factors that could affect the attacks of new-onset CVD in the patients（ P 〈0.01）. Conclusion Significant morbidity rate of new-onset CVD increases in PD patients with DM as compared with that in non DM patients,especially for the new-onset cerebral infarction. Age, sex, DM and infection are the independent risk factors for new-onset CVD in PD patients.