维持性血液透析患者发生不良心血管事件危险因素的分析

目的：探讨维持性血液透析患者发生不良心血管事件的危险因素。方法：选取2009年1月～12月于我科维持性血液透析患者58例,透析时间≥3月。根据不良心血管事件确认标准分为有心血管疾病组28例,无心血管事件组30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、血红蛋白、血浆白蛋白、总蛋白、胆固醇、三酰甘油、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：有心血管事件组年龄、透析龄明显高于无心血管事件组（P〈0.01）;有心血管事件组患者血尿酸、血钙水平高于无心血管事件组（P〈0.05）,而血25-（OH）D3水平在有心血管事件组明显低于无心血管事件组（P〈0.01）;二分类Lo-gistic回归分析显示年龄、透析龄、低密度脂蛋白、钙磷乘积、25-（OH）D3、血尿酸是血液透析患者发生不良心血管事件的重要危险因素。结论：心血管疾病是血液透析患者常见的并发症之一,年龄、透析龄、低密度脂蛋白、钙磷乘积、25-（OH）D3、血尿酸是血透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 Hemodialysis (HD) Patients

Objective：To investigate the risk factors of bad cardiovascular events in maintenance hemodialysis patients.Methods：58 patients with maintenance hemodialysis 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=28） and no bad cardiovascular events group（n=30）.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：Age and dialysis time in bad cardiovascular events group were higher than no bad cardiovascular events group（P0.01）;Serum uric acid and calcium were higher than no bad cardiovascular events group,too（P0.05）; but 25-（OH）D3 in bad cardiovascular events group was lower than no bad cardiovascular events group（P0.01）.Logistic regression analysis showed that age,dialysis time,low density lipoprotein,calcium-phosphorus product and 25-（OH）D3,serum uric acid were the significant risk factors of bad cardiovascular events in maintenance hemodialysis.Conclusion：Cardiovascular events was the most frequent complication in maintenance hemodialysis patients.Age,dialysis time,low density lipoprotein,calcium-phosphorus product and 25-（OH）D3,serum uric acid were the significant risk factors of bad cardiovascular events in maintenance hemodialysis.