维持性腹膜透析患者发生不良心血管事件危险因素的分析

目的 探讨维持性腹膜透析患者发生不良心血管事件的危险因素.方法 选取维持性腹膜透析患者44例,透析时间≥3个月.根据不良心血管事件确认标准分为无心血管事件组24例,有心血管事件组20例.记录两组患者年龄、性别、原发病、透析龄;同时记录血生化指标:血尿酸、血色素、血浆白蛋白、总蛋白、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血钙、血磷、钙磷乘积、全段甲状旁腺素(iPTH)、25-(OH)D3、碱性磷酸酶、尿素氮、肌酐水平.结果 有心血管事件组血浆总蛋白、白蛋白、血肌酐、25-(OH)D3水平均低于无心血管事件组,而年龄、血胆固醇、尿酸水平则明显高于无心血管事件组(p＜0.05或p＜0.01);二分类Logistic回归分析显示血浆白蛋白、胆固醇、低密度脂蛋白、血尿酸、25-(OH)D3可能是腹膜透析患者发生不良心血管事件的危险因素.结论 心血管事件是腹膜透析患者常见的并发症之一,血脂异常、营养不良、高血尿酸、低血25-(OH)D3是腹膜透析患者发生不良心血管事件的重要危险因素.

Analysis of risk factors of bad cardiovascular events in maintenance Peritoneal Dialysis (PD) patients

Objectives To investigate the risk factors of bad cardiovascular events in maintenance peritoneal dialysis patients. Methods 44 patients with maintenance peritoneal dialysis. whose therapy time were all more than 3months were enrolled. According to confirmation standards of bad cardiovascular events, we set bad cardiovascular events group(n-20) and no bad cardiovascular events group(n = 24). Age, gender, primary diseases and dialysis time of two groups were recorded. Serum uric acid, hemoglobin, plasma-albumin, total protein, cholesterol, Triglyceride, high density lipoproteins, low density lipoprotein, calcium, phosphorus, calcium-phosphorus product, parathyroid hormone(iPTH) 、25-(OH) D3, alkaline phosphatase, urea nitrogen, creatinine were recorded, too. Results Plasma-albumin, total protein, creatinine and 25-(OH) D3 in bad cardiovascular events group were lower than no bad cardiovascular events group; but age, cholesterol and uric acid in bad cardiovascular events group were higher than no bad cardiovascular events group(p ＜0.05 or p ＜0.01) ;Logistic regression analysis showed that plasma-albumin, cholesterol, low density lipoprotein, uric acid and 25-(OH)D3 were the significant risk factors of bad cardiovascular events in maintenance peritoneal dialysis. Conclusions Cardiovascular events was the most frequent complication in maintenance peritoneal dialysis patients. Dyslipidemia, malnutrition, high blood uric acid and low 25-(OH) D3 were the significant risk factors of bad cardiovascular events in maintenance peritoneal dialysis.