中国现代医学杂志2023，Vol.33Issue(24)：23-28,6.DOI:10.3969/j.issn.1005-8982.2023.24.005
TG/HDL-C结合CRP/Alb预测腹膜透析患者死亡风险的价值
Value of TG/HDL-C combined with CRP/Alb in predicting mortality risk of patients on peritoneal dialysis
摘要
Abstract
Objective To investigate the value of triglyceride(TG)/high-density lipoprotein cholesterol(HDL-C)combined with C-reactive protein(CRP)/albumin(Alb)in predicting the risk of death among patients on peritoneal dialysis.Methods The clinical data of 197 patients with chronic renal insufficiency undergoing peritoneal dialysis in the Second People's Hospital of Jingdezhen City and the Third People's Hospital of Jingdezhen City from January 2017 to December 2022 were retrospectively analyzed.According to the death of patients on peritoneal dialysis,they were divided into the death group and the survival group,and the clinical data of the two groups were compared.Multivariable stepwise Cox regression was used to analyze the risk factors for death among patients on peritoneal dialysis.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was applied to evaluate the predictive value of TG/HDL-C,CRP/Alb and their combination for death among patients on peritoneal dialysis.Results Forty-six of 197 patients on peritoneal dialysis died,with the mortality rate being 23.35％.The age,proportions of coronary heart disease,diabetes mellitus,hypertension,and statin use,platelet count,white blood cell count,neutrophil count,neutrophil to lymphocyte ratio(NLR),TG/HDL-C,and CRP/Alb in death group were higher than those in the survival group(P＜0.05).The lymphocyte count and the level of total bilirubin in the death group were lower than those in the survival group(P＜0.05).Multivariable stepwise Cox regression revealed that advanced age[(OR)=3.080(95％CI:1.354,7.007)],high NLR[(OR)=4.175(95％CI:1.835,9.496)],high TG/HDL-C[(OR)=2.735(95％CI:1.202,6.221)]and high CRP/Alb[(OR)=3.168(95％CI:1.393,7.206)]were risk factors for death in patients on peritoneal dialysis(P＜0.05).ROC curve analysis showed that the sensitivities of TG/HDL-C,CRP/Alb and their combination in predicting the death of patients on peritoneal dialysis were 86.96％(95％CI:0.564,0.892),84.78％(95％CI:0.541,0.873),and 86.96％(95％CI:0.568,0.893),with the specificities being 87.42％(95％CI:0.572,0.898),82.12％(95％CI:0.522,0.872),and 96.03％(95％CI:0.679,0.982),and the AUCs being 0.863(95％CI:0.785,0.918),0.796(95％CI:0.716,0.867)and 0.930(95％CI:0.870,0.968),respectively(P＜0.05).Conclusions Patients on peritoneal dialysis are at a high risk for death,and most of them die due to cardiovascular events.TG/HDL-C and CRP/Alb can be used to predict the risk for death in patients on peritoneal dialysis,and the combination of the two yields a higher predictive value.关键词
腹膜透析/甘油三酯/高密度脂蛋白胆固醇/C反应蛋白/白蛋白/死亡风险/预测价值Key words
peritoneal dialysis/triglyceride/high-density lipoprotein cholesterol/C-reactive protein/albumin/risk of death/predictive value分类
医药卫生引用本文复制引用
朱雯,江洪涛,程小燕,喻国安..TG/HDL-C结合CRP/Alb预测腹膜透析患者死亡风险的价值[J].中国现代医学杂志,2023,33(24):23-28,6.基金项目
江西省自然科学基金(No:2020BABL206028) （No:2020BABL206028）
