[1]姚 律,黄小抗,朱 琼.慢性肾衰竭患者并发心血管疾病相关危险因素分析[J].陕西医学杂志,2024,(1):55-58,63.[doi:DOI:10.3969/j.issn.1000-7377.2024.01.012]
　YAO Lv,HUANG Xiaokang,ZHU Qiong.Related risk factors affecting cardiovascular diseases in patients with chronic renal failure[J].,2024,(1):55-58,63.[doi:DOI:10.3969/j.issn.1000-7377.2024.01.012]
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慢性肾衰竭患者并发心血管疾病相关危险因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年1期
页码:
55-58,63
栏目:
临床研究
出版日期:
2024-01-31

文章信息/Info

Title:
Related risk factors affecting cardiovascular diseases in patients with chronic renal failure
作者:
姚 律; 黄小抗; 朱 琼
(安徽医科大学安庆医学中心肾内科,安徽 安庆 246003)
Author(s):
YAO Lv; HUANG Xiaokang; ZHU Qiong
(Department of Nephrology,Anqing Medical Center,Anhui Medical University,Anqing 246003,China)
关键词:
慢性肾衰竭;  心血管疾病;  危险因素;  Klotho蛋白;  硫酸对甲酚
Keywords:
Chronic renal failure;  Cardiovascular diseases;  Risk factors;  Klotho protein;  P-cresol sulfate
分类号:
R 692.5
DOI:
DOI:10.3969/j.issn.1000-7377.2024.01.012
文献标志码:
A
摘要:
目的:探究慢性肾衰竭(CRF)患者并发心血管疾病(CVD)的相关危险因素。方法:选取111例CRF维持性血液透析患者作为研究对象,调查CVD发生情况。将其分为CVD组(n=54)、非CVD组(n=57),收集两组一般临床资料,采用Logistic单因素和多因素回归分析,探究CRF患者并发CVD的独立危险因素。结果:两组患者年龄、性别、体重指数(BMI)、合并糖尿病情况、心血管疾病史及原发病差异比较无统计学意义(均P>0.05); CVD组血红蛋白、Klotho蛋白水平均低于非CVD组(均P<0.05),低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)、血清磷酸盐、甲状旁腺激素(PTH)、白细胞介素-6(IL-6)、基质金属蛋白酶-9(MMP-9)、硫酸对甲酚水平均高于非CVD组(均P<0.05); Logistic多因素回归分析显示,血红蛋白、Klotho蛋白下降及TG/HDL-C、IL-6、硫酸对甲酚升高均为CRF连续性血液透析患者发生CVD的独立危险因素(均P<0.05)。结论:血红蛋白和Klotho蛋白的下降以及TG/HDL-C、IL-6和硫酸对甲酚的升高均可增加CRF维持性血液透析患者CVD的风险,血液透析治疗期间应加强对上述危险因素的评估和管理。
Abstract:
Objective:To analyze the related risk factors of cardiovascular diseases(CVD)in patients with chronic renal failure(CRF).Methods:A total of 111 patients with CRF undergoing maintenance hemodialysiswere selected as research subjects.The incidence of CVD was investigated,and the patients were divided into CVD group(n=54)and non-CVD group(n=57).General clinical data of the two groups were collected,and Logistic univariate and multivariate regression analyses were performed to explore the independent risk factors of CVD in patients with CRF.Results:There were no statistically significant differences in age,gender,Body Mass Index(BMI),diabetes mellitus,cardiovascular disease history and primary disease between the two groups(all P>0.05).The levels of hemoglobin and Klotho protein in CVD group were lower than those in non-CVD group(all P<0.05),while the levels of low density lipoprotein cholesterol(LDL-C),triglyceride(TG)/high density lipoprotein cholesterol(HDL-C),serum phosphate,parathyroid hormone(PTH),interleukin-6(IL-6),matrix metalloproteinase-9(MMP-9)and p-cresol sulfate were higher than those in non-CVD group(all P<0.05).Logistic multivariate regression analysis showed that the decreases of hemoglobin and Klotho protein and the increases of TG/HDL-C,IL-6 and p-cresol sulfate were independent risk factors of CVD in patients with CRF undergoing maintenance hemodialysis(all P<0.05).Conclusion:The decreases of hemoglobin and Klotho protein and the increases of TG/HDL-C,IL-6 and p-cresol sulfate can increase the risk of CVD in patients with CRF undergoing maintenance hemodialysis,and it is necessary to strengthen the evaluation and management of these risk factors during hemodialysis treatment.

参考文献/References:

[1] 陈丽颖,张林,傅敏,等.矿物元素及炎症因子水平对慢性肾衰竭患者并发脑血管疾病的预测价值[J].湖南师范大学学报(医学版),2022,19(5):63-67.
[2] 姚向飞,刘华,蔡东,等.铁蛋白、钙、磷、甲状旁腺激素水平与维持性血液透析患者预后关系研究[J].陕西医学杂志,2023,52(3):297-300.
[3] 曹丽,曹雷,常露元.低钙腹膜透析液对慢性肾衰竭患者血清钙磷代谢、肾损伤及残余肾功能的影响[J].海南医学,2021,32(15):1946-1949.
[4] 华佳,张悦,李瑞雪,等.慢性肾功能衰竭的腹膜透析患者短期预后不良的影响因素分析[J].国际泌尿系统杂志,2023,43(4):693-697.
[5] 马琴琴,周莹,张艳楠,等.连续肾替代治疗慢性肾衰竭重症患者的疗效及其预后的影响因素分析[J].临床肾脏病杂志,2022,22(9):712-718.
[6] 刘华,谷东东.低钙透析对血液透析患者钙磷代谢紊乱的影响研究[J].山西医药杂志,2021,50(12):1955-1957.
[7] 刘章锁,王沛.K/DOQI指南关于慢性肾脏病分期的临床指导意义[J].中国实用内科杂志,2008,28(1):21-24.
[8] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789.
[9] 徐慧,崔益鸿,翁丽娜,等.营养干预对肾衰竭维持性血液透析患者营养状况及钙磷代谢的影响[J].中国食物与营养,2021,27(3):72-75.
[10] SOLOMON S D,MCMURRAY J J V,CLAGGETT B,et al.Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction[J].N Engl J Med,2022,387(12):1089-1098.
[11] 陈秀娟,朱昭明,苏宝印.参芪清毒胶囊对血液透析患者营养指标、氧化应激、炎性因子、残余肾功能的影响[J].陕西中医,2021,42(3):334-337.
[12] 李琳,崔珺,崔艳,等.hs-CRP、NLR及FGF23对慢性肾衰竭维持性血液透析患者的预后评估价值[J].西部医学,2021,33(11):1633-1636.
[13] 李娟,卢婉君,龚书豪,等.慢性肾衰竭腹膜透析患者微炎症状态的研究进展[J].南昌大学学报(医学版),2021,61(3):80-83.
[14] 孜娜提古丽?萨伍提,帕热旦木?托乎提,李玉芳.维持性血液透析患者血清DHEA-S水平与心血管疾病的相关性研究[J].中国中西医结合肾病杂志,2021,22(1):64-65.
[15] 张媛,朱小静.维持性血液透析患者骨硬化蛋白,Klotho蛋白水平变化及与冠状动脉钙化相关性分析[J].陕西医学杂志,2021,50(10):1246-1249.
[16] 陈桢,高丽萍.慢性肾衰竭患者血清Cys C、β2-MG、MCP-1及ANGⅡ水平变化及临床意义[J].昆明医科大学学报,2021,42(2):130-136.
[17] 杭孝佳,刘永梅,杨杰,等.AVF与TCC血管通路在慢性肾衰竭患者中的血液透析效果比较及对炎性因子、营养水平和肾功能的影响[J].现代生物医学进展,2022,22(18):3539-3543.
[18] VOORS A A,ANGERMANN C E,TEERLINK J R,et al.The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure:A multinational randomized trial[J].Nat Med,2022,28(3):568-574.
[19] 唐强帮.慢性肾功能衰竭患者联合血液透析与血液灌流治疗的效果和安全性评价[J].中国全科医学,2021,24(2):43-45.
[20] WHEELER D C,STEFANSSON B V,JONGS N,et al.Effects of dapagliflozin on major adverse kidney and cardiovascular events in patients with diabetic and non-diabetic chronic kidney disease:A prespecified analysis from the DAPA-CKD trial[J].Lancet Diabetes Endocrinol,2021,9(1):22-31.
[21] BOHM M,ANKER S D,BUTLER J,et al.Empagliflozin improves cardiovascular and renal outcomes in heart failure irrespective of systolic blood pressure[J].J Am Coll Cardiol,2021,78(13):1337-1348.
[22] 杜艳梅,田展松,李红,等. ApoE 基因多态性、Hcy与2型糖尿病患者发生冠状动脉粥样硬化性心脏病的相关性研究[J].空军军医大学学报,2023,44(8):717-720.
[23] 韩宝侠,姜小梅,申媛文,等.终末期肾衰竭维持血液透析患者的血清代谢组学研究[J].中国医院药学杂志,2021,41(9):905-911.
[24] 李丽霞,李娜.血清MAO和IL-6水平诊断慢性肾衰竭并发心力衰竭的价值及与心功能分级的关系[J].现代检验医学杂志,2023,38(1):147-150.
[25] FILIPPATOS G,BUTLER J,FARMAKIS D,et al.Empagliflozin for heart failure with preserved left ventricular ejection fraction with and without diabetes[J].Circulation,2022,146(9):676-686.
[26] 梁晓玲,张春山,江琛.单核细胞与高密度脂蛋白胆固醇比值是慢性肾衰竭血液透析患者2年内死亡的独立影响因素[J].内科急危重症杂志,2023,29(2):141-145.

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备注/Memo

备注/Memo:
基金项目:安徽省高校自然科学研究项目(2022AH04032)
更新日期/Last Update: 2024-01-05