上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (8): 1120-.doi: 10.3969/j.issn.1674-8115.2017.08.014?

• 论著（临床研究） • 上一篇    下一篇

冠状动脉钙化积分与腹膜透析患者预后的相关性研究#br#

晏焕青 1，谢琼虹 2，尚达 2，朱彤莹 1, 2   

  1. 复旦大学  1. 附属华山北院宝山分院（宝山区仁和医院）肾内科，上海 200431；2. 附属华山医院肾内科，上海 200040
  • 出版日期:2017-08-28 发布日期:2017-09-28
  • 通讯作者: 朱彤莹，电子信箱：zhuty25@163.com
  • 作者简介:晏焕青（1982—），女，主治医师，硕士；电子信箱：flynowhere@126.com
  • 基金资助:
    宝山区卫生青年医学人才培养计划（bswsyq-2015-A06）

Correlation analysis of coronary artery calcification score and prognosis of peritoneal dialysis patients#br#

YAN Huan-qing1, XIE Qiong-hong2, SHANG Da2, ZHU Tong-ying1, 2   

  1. 1. Department of Nephrology, Huashan Hospital North, Baoshan Branch, Fudan University, Shanghai 200431, China; 2. Department of Nephrology, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Online:2017-08-28 Published:2017-09-28
  • Supported by:
    Health Youth Medical Talents Training Program of Baoshan District, bswsyq-2015-A06

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摘要： 目的 · 评价冠状动脉钙化积分（CaCS）与腹膜透析患者预后的相关性。方法 · 选择透析龄 2 个月以上的临床状况稳定的腹膜 透析患者，采用多层螺旋计算机断层扫描检测 CaCS，按 CaCS 的分值将患者分为无钙化组、低分钙化组和高分钙化组，比较 3 组患 者的基本资料和终点事件（包括全因死亡、心血管事件和心血管死亡）发生率，分析 CaCS 与终点事件的相关性。结果 · 共入选 254 名患者，其中男性 132 名，平均年龄（62.9±15.0）岁；其中无钙化组 93 例，低分钙化组 105 例，高分钙化组 56 例。与无钙化组相 比，CaCS 较高的患者年龄更大，舒张压、残余肾功能和血清白蛋白更低，糖化血红蛋白和血清胰岛素水平更高。多因素 Cox 回归分 析显示，在腹膜透析患者中 CaCS 是所有终点事件的独立的危险因素。结论 · CaCS 是腹膜透析患者全因死亡、心血管事件和心血管 死亡的独立危险因素。

关键词: 冠状动脉钙化积分, 腹膜透析, 预后, 心血管事件, 危险因素

Abstract:

Objective · To estimate correlation between coronary artery calcification score (CaCS) and prognosis of peritoneal dialysis (PD) patients.  Methods · The clinically stable patients who had undergone PD for at least 2 months were recruited for this prospective and observational cohort study. Coronary artery calcification was assessed by multislice spiral computed tomography and was recorded according to the Agatston score. The patients were assigned to 3 groups, i.e. no calcification group (CaCS=0), low calcification group (0<CaCS<400) and high calcification group (CaCS ≥ 400), to compare their basic data and endpoint events (including all-cause mortality, cardiovascular events and cardiovascular mortality). And then the correlation between CaCS and endpoint events was analyzed.  Results · A total of 254 PD patients (including 132 males) with a mean age of (62.9±15.0) years were recruited for this study. There were 93, 105, and 56 cases in no calcification group, low calcification group and high calcification group, respectively. Compared with no calcification group, patients with higher CaCS were older, had lower diastolic blood pressure, residual renal function, and serum albumin, and had higher glycosylated hemoglobin and serum insulin. Multivariate Cox regression revealed that CaCS was an independent risk factor for all the three endpoint events in PD patients.  Conclusion · CaCS was an independent predictor of all-cause mortality, cardiovascular events and cardiovascular mortality in PD patients.

Key words: coronary artery calcification score, peritoneal dialysis, prognosis, cardiovascular event, risk factor