维持性血液透析患者血镁水平与心脏瓣膜钙化的关系

摘要

目的:探讨维持性血液透析(maintenance hemodialysis,MHD)患者血镁与心脏瓣膜钙化(cardiar valve calcification, CVC)的关系.方法:选取年龄≥18岁、MHD≥3个月的患者.收集入选患者临床及血生化资料,采用超声心动图检查 CVC 情况.采用 Logistic 回归法分析血镁与 CVC 的关系.结果:①149例MHD 患者血镁水平为1.08±0.16mmoL/L,高血镁者100例(67.1%),正常血镁者49例(32.9%);存在CVC者98例(65.8%);高血镁组发生CVC 者60例(60.0%)显著低于正常血镁组的38例(77.6%)(P<0.05).②CVC组患者的年龄、透析龄、冠心病、校正钙及血磷水平显著高于无 CVC 组(均P<0.05),无CVC组血镁水平、高血镁发生率显著高于CVC组(均P<0.05).③多因素Logistic回归分析显示:血镁与CVC呈独立负相关(P=0.001);年龄、透析龄、血磷与 CVC 呈独立正相关(均 P<0. 05).血镁与二尖瓣钙化(mitral valve calcificationotic,MVC)、主动脉瓣钙化(aortic valve calcification, AVC)及两瓣膜同时钙化(MVC+AVC)独立负相关(均 P<0.05);血磷与 MVC、AVC 及 MVC+AVC 独立正相关(均P<0.05);透析龄与MVC独立正相关(P<0.05),年龄与AVC独立正相关(P<0.001).结论:MHD患者血镁水平、高血镁及CVC 患病率高;高血镁可降低MHD患者CVC 发生率;高血磷是 CVC 的独立危险因素.%Objective:To explore the relation between serum magnesium and cardiar valve calcification (CVC) in maintenance hemodialysis(MHD) patients. Methods: Patients with age≥18 years old,mainte-nance hemodialysis for≥3 months were enrolled in this study.We collected their clinical data and blood bio-chemical indexes,CVC was measured by echocardiography. Logistic regression was used to analyze the relation between serum magnesium and CVC. Results:①Among 149 MHD patients,serum magnesium average was 1. 08±0.16mmol/L and 100 cases were high serum magnesium (67.1%),49 cases were normal serum magnesi-um(32.9%).98 cases were with CVC (65.8%). There were 60 cases with CVC (60.0%) in the high blood magnesium group,which were significantly lower than those 38 with CVC in the normal serum magnesium. ②Age,dialysis age,coronary heart disease, correction of calcium and serum scale were significantly higher in CVC group than non-CVC group(P <0.05). Serum magnesium level and the incidence of high serum magne-sium were significantly higher in non-CVC group than CVC group (P <0.05). ③Logistic regression analysis dispaly:Serum magnesium was independent negatively associated with CVC (P = 0.001); age, dialysis age,serum phosphorus were independent positively associated with CVC (P<0.05). Serum magnesium was independently negatively associated with MVC,AVC,MVC and AVC (P<0.05). Serum phosphorus was inde-pendently positively associated with MVC,AVC,MVC and AVC (P<0.05). Dialysis age was independently positively associated with MVC (P<0.05). Age was independently positively associated with AVC (P<0.001). Conclusion: The higher prevalence of serum magnesium, the higher serum magnesium and CVC in MHD patients,high serum magnesium can reduce the incidence of CVC in MHD patients; high serum phos-phorus is an independent risk factor for CVC.