单中心维持性血液透析患者PTH与hs-cTnI水平的相关性研究

目的　探讨维持性血液透析患者甲状旁腺素（PTH）与超敏肌钙蛋白I（hs-cTnI）水平的相关性。方法　回顾性分析2020年1月至6月在南方医科大学附属花都医院维持性血液透析的慢性肾脏病（CKD）5期患者290例为研究对象。按照PTH水平分为3组，分析PTH水平与hs-cTnI阳性的相关关系。数据采用独立样本t检验、单变量方差分析、秩和检验、χ²检验及logistic回归方程等进行统计分析。结果　纳入290例符合入选条件的维持性血液透析患者，年龄（58.94±14.16）岁，其中男性占比57.59%（167/290），透析龄中位数为31个月，PTH（52.23±46.97）pmol/L，hs-cTnI阳性率为5.86%（17/290）。单因素分析结果显示，hs-cTnI阳性（>0.1 μg/L）的维持性血液透析患者男性占比、透析前B型钠尿肽、尿素氮、肌红蛋白、血钙、PTH水平均显著高于hs-cTnI阴性的患者，差异均有统计学意义（均P<0.05）。多元logistic回归分析显示，PTH每增加10.00 pmol/L，血液透析患者hs-cTnI阳性的效应值增加14%（OR=1.14，95%CI：1.01～1.27，P=0.029）。结论　维持性血液透析患者PTH水平与心肌损伤存在一定关联。

Correlation between PTH and hs-cTnI levels in patients undergoing single-center maintenance hemodialysis

Objective　To investigate the correlation between parathyroid hormone (PTH) and high-sensitivity troponin I (hs-cTnI) in patients undergoing maintenance hemodialysis. Methods　A retrospective study was conducted on 290 patients with chronic kidney disease (CKD) at stage 5 undergoing maintenance hemodialysis in Huadu Hospital of Southern Medical University from January to June 2020. The patients were divided into 3 groups according to the PTH level, and the correlation between PTH level and hs-cTnI positive rate was analyzed. The data were statistically analyzed by independent sample t test, univariate analysis of variance, rank-sum test, χ² test, and logistic regression equation. Results　A total of 290 eligible maintenance hemodialysis patients were included, aged (58.94±14.16) years, with male patients of 57.59% (167/290), a median dialysis age of 31 months, PTH of (52.23±46.97) pmol/L, and a positive rate of hs-cTnI of 5.86% (17/290). Univariate analysis showed that the proportion of males and the levels of B-type natriuretic peptide, urea nitrogen, myoglobin, serum calcium, and PTH before dialysis in the hs-cTnI positive (>0.1 μg/L) patients were significantly higher than those in the hs-cTnI negative patients, with statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that every 10.00 pmol/L increase of PTH increased the hs-cTnI positive effect value in hemodialysis patients by 14% (OR=1.14, 95%CI: 1.01-1.27, P=0.029). Conclusion　The PTH level is associated with myocardial injury in maintenance hemodialysis patients.