106例血液透析患者心血管疾病的危险因素分析

目的探讨血液透析患者心血管疾病的危险因素。方法常规检测106例维持性血液透析患者的血脂、血清白蛋白(ALB)、尿素清除指数(KT/V)、尿酸、血磷及血压水平,并分析上述因素与血液透析患者心血管疾病之间的关系。结果血液透析患者心血管疾病为25%,其中缺血性心脏病6例,心功能不全5例,心脏增大21例,脑血管意外3例。伴心血管疾病的血液透析患者血清甘油三酯(TG)水平、年龄、透析前血清肌酐、尿酸、白蛋白、伴有高血压和心血管病变家族史的比例显著高于无心血管疾病患者,KT/V、透析时体外循环血量和超滤量显著低于后者。逐步条件logistic回归分析结果显示,年龄、高血压、TG、血磷、ALB是心血管疾病的重要危险因素,回归方程为P/(1-P)=exp(-12.81 0.239年龄 0.288高血压 1.586TG 4.270血磷-0.439ALB)。结论高血压、高龄、血清甘油三酯水平和血磷水平增高、血清白蛋白水平降低是血液透析患者心血管疾病的危险因素,血液透析不充分、透析时的体外血循环量及心血管家族史也与心血管疾病的发生有关。

Analysis for the risk factors of cardiovascular disease in hemodialysis patients

Objective To investigate the risk factors of cardiovascular disease(CVD) in hemodialysis patients.Methods The levels of serum lipids,serum albumin,serum phosphate,serum uric acid,KT/V and blood pressure were measured,and the relationships between the above factors and cardiovascular disease were analyzed in hemodialysis patients.Results The incidence of vascular disease in hemodialysis patients was 25 percent (26/104),six of them were ischemic heart disease,five were cardiac insufficiency,twenty-one were cardiac enlargement,and three were cerebrovascular accident.The levels of blood pressure,serum triglyceride,creatinine,and serum uric acid in hemodialysis patients with CVD were higher significantly than those in the patients without CVD.The levels of KT/V,serum albumin, blood volume of cardiopulmonary bypass and the volume of ultrafiltration were lower significantly in the former than those in the latter.It had been shown by logistic regressive analysis that hypertension, the level of serum triglyceride,albumin and phosphate,and the age were the important risk factors of cardiovascular disease in emodialysis patients.Diagnostic formula was as the following:P/(1-P)=exp(-12.8 0.288*hypertension 1.586*TG 4.270*serum phosphate 0.239*age-0.439*serum albumin).Conclusion Hypertension,the level of serum triglyceride,albumin and phosphate,and the age were the important risk factors of cardiovascular disease in hemodialysis patients,The levels of KT/V,blood volume of cardiopulmonary bypass and the volume of ultrafiltration,the level of serum uric acid also might contribute to the CVD in hemodialysis patients.