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腹膜透析患者残肾功能与主要不良心血管事件发生的相关性OACSTPCD

Correlation between residual renal function and major adverse cardiovascular events in peritoneal dialysis patients

中文摘要英文摘要

目的 探讨腹膜透析患者残肾功能与主要不良心血管事件(major adverse cardiovascular events,MACE)发生的相关性,分析残肾功能及其他临床影响因素对MACE发生的风险预测效能.方法 前瞻性选取2021年2月至2023年6月行腹膜透析治疗的患者198例,根据患者6个月内的MACE发生情况分为发生MACE组(n=42)和未发生MACE组(n=156),使用医院电子病例系统收集患者的残肾功能和一般临床资料,通过单因素分析及多因素logistic回归分析腹膜透析患者发生MACE的独立影响因素,采用患者工作特征(receiver operating characteristic,ROC)曲线分析残肾功能及其他临床影响因素对发生MACE的评估价值.结果 单因素分析及多因素logistic回归分析结果显示,残肾功能指标中的血清尿素氮、残肾肾小球滤过率(glomerular filtration rate,GFR)、残肾肌酐清除率(creatinine clearance rate,Ccr)、残肾 Kt/V(urea clearance in-dex,Kt/V)以及临床资料中的吸烟史、肾病病程、心功能分级、合并高血压均是发生MACE的独立影响因素,差异有统计学意义(P<0.05).ROC曲线分析结果显示,残肾功能指标单独及联合预测MACE发生的效能均良好.结论 腹膜透析患者残肾功能指标水平普遍偏低,血清尿素氮、残肾GFR、残肾Ccr、残肾Kt/V水平均与MACE发生密切相关,以上指标单独或联合检测对腹膜透析患者发生MACE均具有良好的评估效果.

Objective To investigate the correlation between residual renal function and the occurrence of major adverse cardiovascular events(MACE)in peritoneal dialysis(PD)patients and to evaluate the predictive efficacy of re-sidual renal function and other clinical factors on MACE risk.Methods A total of 198 patients who underwent peritoneal dialysis from February 2021 to June 2023 were prospectively enrolled.Patients were divided into two groups based on the occurrence of MACE within six months:MACE group(n=42)and non-MACE group(n=156).Clinical data,inclu-ding residual renal function parameters,were collected through the hospital's electronic medical record system.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for MACE,and the receiver operating characteristic(ROC)curve was used to assess the predictive value of residual renal function and other clinical factors for MACE.Results Both univariate and multivariate logistic regression analyses indicated that serum urea nitro-gen,residual glomerular filtration rate(GFR),residual creatinine clearance rate(Ccr),residual Kt/V(urea clearance index),along with smoking history,duration of kidney disease,cardiac function classification,and hypertension were in-dependent predictors of MACE in PD patients(P<0.05).ROC curve analysis demonstrated that individual and combined residual renal function parameters had good predictive efficacy for MACE occurrence.Conclusion Residual renal func-tion parameters in PD patients are generally reduced,with serum urea nitrogen,residual GFR,residual Ccr,and residual Kt/V levels closely related to MACE occurrence.These indicators,either individually or in combination,effectively pre-dict the risk of MACE in PD patients.

石新慧;任东升;鲁冰;谷裕;徐光

南阳市中心医院肾病内科(河南南阳 473005)

临床医学

腹膜透析残肾功能主要不良心血管事件危险因素

peritoneal dialysisresidual renal functionmajor adverse cardiovascular eventsrisk factors

《广东医学》 2024 (012)

1606-1611 / 6

南阳市科技攻关计划项目(KJGG144)

10.13820/j.cnki.gdyx.20240816

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