腹透患者心血管钙化的发生率、分布特点及相关影响因素

目的：通过对腹膜透析患者的心脏瓣膜钙化及主动脉弓钙化进行评价，分析心血管钙化的发生率、分布特点及相关影响因素。方法选取174例腹膜透析患者，分别于统一时间段测量肢肱动脉血压，分别记录患者的血尿素氮、肌酐值；24 h的尿量、透出液量、尿素氮、肌酐值及透出液尿素氮、肌酐浓度值；并通过上述测定值计算评估透析充分性和残余肾功能。每隔6个月测定患者的生化指标。对腹膜透析患者心脏进行多普勒超声检查和患者胸部X线片检查，用Logistics回归分析评判心血管钙化危险因素。结果主动脉弓钙化及瓣膜钙化类别中钙化患者的年龄、透析龄及血磷值均高于非钙化患者（ P ＜0．05）；钙化患者的残余肾功能值显著低于非钙化患者（ P ＜0．05）；随着年龄／透析龄的增加，瓣膜／主动脉弓钙化的发生率显著上升（ P ＜0．05）。年龄、透析龄和钙磷乘积均是影响心脏瓣膜钙化的独立危险因素（ P ＜0．05），其中钙磷乘积危险系数最高；年龄、透析龄和血磷是影响主动脉弓钙化的独立危险因素（ P ＜0．05），其中血磷危险系数最高；残余肾功能是能影响心脏瓣膜／主动脉弓钙化的独立因素（ P ＜0．05），而且是保护因素。结论年龄和透析龄是影响心脏瓣膜钙化及主动脉弓钙化的独立危险因素，钙磷乘积是影响心脏瓣膜钙化危险系数最高的独立因素，血磷是影响主动脉弓钙化危险系数最高的独立因素。

The incidence rate,distribution characteristics and related influencing factors of cadiovascular calcification in peritoneal dialysis patients

Objective To evaluate the cardiac valve calcification and aortic arch calcification in peritoneal dialysis patients, and to analyze the incidence rate , distribution characteristics and related influencing factors of cadiovascular calcification.Methods One hundred and seventy -four patients who underwent peritoneal dialysis in our hospital were enrolled in the study.The patient’s blood pressure of brachial artery was measured in unification time point ,and blood urea nitrogen,creatinine values, 24-hour urine volume,dialysis liquid volume,urea nitrogen,creatinine and contents of urea nitrogen and creatinine in dialysis liquid were detected to evaluate the dialysis efficiency and residual renal function of patients .The biochemical indicators of patients were detected at an interval of 6 months, moreover, the patients received Doppler ultrasonography and chest X-ray examination,finally, the risk factors influencing cardiovascular calcification were evaluated by Logistics regression.Results The average age [(63 ±14)years],dialysis duration and serum levels of phosphorus in patients with aortic arch calcification and heart valve calcification were significantly higher than those of patients without calcification (P<0.05), and residual renal function values were significantly lower than those of of patients without calcification ( P <0.05).The incidence of cardiac valve calcification and aortic arch calcification was significantly increased along with the growth of patient’s age and dialysis duration ( P <0.05).The patient's age, dialysis duration and calcium-phosphorus product were independent risk factors influencing cardiac valve calcification ( P <0.05),in which, the danger coefficient of calcium-phosphorus product was the highest ,moreover, patient’ s age,dialysis duration and serum levels of phosphorus were independent risk factors influencing aortic arch calcification ( P <0.05),in which, the danger coefficient of serum levels of phosphorus was the highest ( P <0.05).Besides residual renal function of patients was independent risk factors influencing cardiac valve calcification and aortic arch calcification,furthermore,which was protection factor.Conclusion The patient’s age and dialysis duration are independent risk factors influencing cardiac valve calcification and aortic arch calcification.The calcium-phosphorus product is independent factor influencing cardiac valve calcification , with the highest danger coefficient , besides, the serum level of phosph is independent factor influencing aortic arch calcification , with the highest danger coefficient.