摘要
目的探讨终末期肾病维持性血液透析(MHD)患者血清胎球蛋白A(Fetuin A)、红细胞分布宽度(RDW)对不良心血管事件的预测价值。方法收集2019年6月至2021年12月期间在本院行MHD的203例终末期肾病患者的临床资料,根据是否发生不良心血管事件,将患者分为无心血管事件组118例和心血管事件组85例;收集患者临床资料,采用ELISA法检测血清Fetuin A水平,ROC曲线分析血清Fetuin A、RDW对MHD患者发生心血管事件的预测价值;Logistics回归分析MHD患者发生心血管事件的影响因素。结果无心血管事件组与心血管事件组患者之间年龄、性别、透析龄、透析脱水比、糖尿病患者比例及白蛋白(ALB)、尿素氮(BUN)、尿酸(UA)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平之间比较,差异无统计学意义(P>0.05);与无心血管事件组比较,心血管事件组高血压患者比例、血磷、血钙、甲状旁腺激素(iPTH)、血肌酐(sCr)、三酰甘油(TG)、C反应蛋白(CRP)、NT-proBNP水平、RDW值显著升高,血红蛋白(Hb)、Fetuin A水平降低(P<0.05);血清Fetuin A联合RDW值预测MHD患者发生心血管事件的灵敏度为75.29%,特异性为94.07%,曲线下面积为0.897(95%CI 0.847~0.935);Logistics多因素回归分析显示,有高血压史、血磷、NT-proBNP、TG、RDW值升高是影响MHD患者发生心血管事件的危险因素,Fetuin A升高是影响MHD患者发生心血管事件的保护因素(P<0.05)。结论RDW值增加与低水平的Fetuin A是MHD终末期肾病患者发生心血管事件的独立危险因素,对预测MHD终末期肾病患者发生心血管事件有一定价值。
Objective To investigate the predictive value of serum Fetuin A and red blood cell distribution width(RDW)for adverse cardiovascular events in patients with end-stage renal disease undergoing maintenance hemodialysis(MHD).Methods The clinical data of 203 patients with end-stage renal disease who underwent MHD in our hospital from June,2019 to December,2021 were collected for the analysis.According to the occurrence of adverse cardiovascular events,these patients were grouped into the no-cardiovascular event group(118 cases)and the cardiovascular event group(85 cases).The clinical data from all patients were collected.The level of serum Fetuin A was detected by ELISA.ROC curve was drawn to analyze the predictive value of serum Fetuin A and RDW for cardiovascular events in MHD patients;Logistic regression was used to identify the influencing factors of cardiovascular events in MHD patients.Results There was no significant difference in age,sex,dialysis age,dialysis dehydration ratio,the proportion of diabetes patients,and levels of albumin(ALB),urea nitrogen(BUN),uric acid(UA),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)between patients without cardiovascular events and patients with cardiovascular events(P>0.05);Compared with the group without cardiovascular events,the proportion of hypertensive patients in the cardiovascular event group,as well as blood phosphorus,blood calcium,parathyroid hormone(iPTH),blood creatinine(sCr),triglycerides(TG),C-reactive protein(CRP),NT proBNP levels,and RDW values were all significantly increased,while hemoglobin(Hb)and Fetin A levels were decreased(P<0.05);The sensitivity of serum Fetuin A combined with RDW in predicting cardiovascular events in MHD patients was 75.29%,with the specificity of 94.07%,and the area under the curve of 0.897(95%CI 0.847-0.935);Logistic multivariate regression analysis showed that a history of hypertension,elevated blood phosphorus,NT proBNP,TG,and RDW values were risk factors for cardiovascular events in MHD patients,while elevated Fetuin A was a protective factor for cardiovascular events in MHD patients(P<0.05).Conclusion Increased RDW values and low levels of Fetuin A are independent risk factors for cardiovascular events in MHD patients with end-stage renal disease,which have certain value in predicting cardiovascular events in MHD patients with end-stage renal disease.
作者
方倩
郭磊
顾铜
FANG Qian;GUO Lei;GU Tong(Hemodialysis Room,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China;Department of Oncology,Tianjin Haihe Hospital,Tianjin 300000,China)
出处
《标记免疫分析与临床》
CAS
2024年第2期298-302,共5页
Labeled Immunoassays and Clinical Medicine
基金
秦皇岛市科学技术研究与发展计划(编号:202004A110)。
关键词
终末期肾病
维持性血液透析
胎球蛋白A
红细胞分布宽度
不良心血管事件
End-stage renal disease
Maintenance hemodialysis
Fetuin A
Red blood cell distribution width
Adverse cardiovascular events
