腹膜透析患者发生心血管事件的危险因素分析

摘要

目的：探讨持续性腹膜透析患者发生心血管事件的危险因素。方法180例持续性腹膜透析患者，按12个月内有无心血管事件发生分成心血管事件组（73例）和无心血管事件组（107例），对比分析两组患者的临床资料、生化指标等，采用logistic回归分析不良心血管事件的危险因素。结果两组患者在性别、年龄、原发病、透析疗程、透析前血压、吸烟史、血红蛋白水平、营养状况等方面比较差异均无统计学意义（ P均＞0．05）；心血管事件组患者血清总胆固醇、低密度脂蛋白胆固醇（ LDL-C ）、血清铁、血清铁蛋白、转铁蛋白饱和度、血磷、全段甲状旁腺激素（iPTH）、高敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）、肿瘤坏死因子-α（TNF-α）及铁调素（Hepcidin-25）水平均高于无心血管事件组（P均＜0．01）。 logistic回归分析结果显示：血清总胆固醇、血清Hepcidin-25和TNF-α水平是持续性腹膜透析患者发生不良心血管事件的重要危险因素。结论血清总胆固醇、血清Hepcidin-25和TNF-α水平是导致持续性腹膜透析患者发生不良心血管事件的重要危险因素。%Objective To evaluate the risk factors for cardiovascular event in patients with continuous peritoneal dialysis.Methods One hundred and eighty patients with continuous peritoneal dialysis were divided into cardiovascular event group(73 cases) and non-cardiovascular event group (107 cases) according to the occurrence of cardiovascular events in 12 months.The clinical data and biochemical indicators of patients in both groups were analyzed .The logistic regression analysis was used to analyze the risk factors for adverse cardiovascular event .Results There was no significant difference in gender,age,primary disease,dialysis duration,the blood pressure before dialysis treatment ,smoking history, hemoglobin level and nutritional status between cardiovascular event group and non-cardiovascular event group ( all P>0 .05 ) .The levels of serum total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , serum iron , serum ferritin,transferrin saturation,blood phosphorus,serum intact parathyroid hormone(iPTH),high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy),tumor necrosis factor alpha(TNF-α) and hepcidin-25 of cardiovascular event group were higher than those of non-cardiovascular event group ( all P<0 .01 ) .The logistic regression analysis results showed that the levels of serum total cholesterol ,serum hepcidin-25 and TNF-αwere important risk factors for adverse cardiovascular events in patients with continuous peritoneal dialysis .Conclusion The levels of serum total cholesterol , serum hepcidin-25 and TNF-αare important risk factors for adverse cardiovascular events in continuous peritoneal dialysis patients.