摘要
目的探讨血清同型半胱氨酸对血液透析患者发生冠状动脉钙化(CAC)的预测价值。方法回顾性分析2019年10月至2021年5月入住安徽医科大学第二附属医院肾脏内科的119例血液透析患者,收集临床资料和实验室检查数据,根据多层螺旋计算机断层扫描(MSCT)测定冠状动脉钙化积分(CACS)结果,分为钙化组(70例)和无钙化组(49例)。比较两组患者的临床资料;通过多因素logistic回归分析血液透析患者发生CAC的危险因素;绘制受试者工作特征(ROC)曲线,评估同型半胱氨酸对CAC的预测价值。结果两组患者性别、高血压、体质量指数(BMI)、甘油三酯、校正钙、血磷、血尿酸、白蛋白、总胆固醇、肌酐、全段甲状旁腺激素(iPTH)及是否服用磷结合剂治疗比较,差异无统计学意义(P>0.05);两组患者年龄、透析龄、C反应蛋白(CRP)及同型半胱氨酸比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,高龄、高同型半胱氨酸是影响血液透析患者发生CAC的独立危险因素(P<0.05);ROC曲线分析结果显示,同型半胱氨酸与年龄联合预测CAC发生的曲线下面积为0.850(95%CI:0.781~0.918,P<0.001)。结论高龄、高同型半胱氨酸的血液透析患者发生CAC的风险较大,且同型半胱氨酸与年龄的联合指标对血液透析患者CAC的发生有较好的预测价值。
Objective To investigate the predictive value of serum homocysteine for coronary artery calcification(CAC)in hemodialysis patients.Methods A total of 119 hemodialysis patients admitted to the Nephrology Department in the Second Affiliated Hospital of Anhui Medical University from October 2019 to May 2021 were retrospectively analyzed.The clinical data and laboratory data were collected.The patients were divided into calcification group(70 cases)and non-calcification group(49 cases)according to the results of coronary artery calcium score(CACS)measured by multislice spiral computed tomography(MSCT).The clinical data of the two groups were compared.The risk factors for CAC in hemodialysis patients were analyzed by multiple logistic regression,and receiver operating characteristic(ROC)curves were plotted to assess the predictive value of homocysteine for CAC.Results There were no differences in gender,hypertension,body mass index(BMI),triglyceride,corrected calcium,serum phosphorus,blood uric acid,albumin,total cholesterol,creatinine,intact parathyroid hormone(iPTH)and whether to take phosphate binders between the two groups(P>0.05).There were differences in age,dialysis age,C-reaction protein(CRP)and homocysteine between the two groups(P<0.05).Multiple logistic regression analysis showed that advanced age and hyperhomocysteine were independent risk factors for CAC in hemodialysis patients(P<0.05).ROC curve analysis showed that the area under the curve of homocysteine combined with age in predicting CAC was 0.850(95%CI:0.781-0.918,P<0.001).Conclusion The risk of CAC is higher in elderly hemodialysis patients with high homocysteine,and the combined index of homocysteine and age has a good predictive value for the occurrence of CAC in hemodialysis patients.
作者
王志娟
刘桂凌
WANG Zhijuan;LIU Guiling(Department of Nephrology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)
出处
《河南医学研究》
CAS
2022年第5期786-790,共5页
Henan Medical Research
基金
安徽省第三批卫生计生适宜技术推广项目(2018-TG04)。
