临床误诊误治2025，Vol.38Issue(15)：42-46,62,6.DOI:10.3969/j.issn.1002-3429.2025.15.009
血清白蛋白、脂蛋白-a与慢性肾衰竭维持性血液透析患者预后不良的相关性
Correlation between Serum Albumin,Lipoprotein-a and Poor Prognosis in Patients with Chronic Renal Failure Undergoing Maintenance Hemodialysis
摘要
Abstract
Objective To investigate the correlation between serum albumin,lipoprotein-a(Lp-a)and poor prognosis in patients with chronic renal failure(CRF)undergoing maintenance hemodialysis(MHD).Methods A total of 152 patients with stage 5 CRF who were scheduled to receive MHD treatment from January 2021 to October 2023 were selected as the research subjects.Serum albumin and Lp-a levels were detected in all the patients upon enrollment.The survival status of all the patients in the research group within 12 months was statistically analyzed,based on which they were divided into the good prognosis group and the poor prognosis group.The correlations between serum albumin,Lp-a and the clinical prognosis of MHD in CRF patients were analyzed by statistical methods,including multivariate logistic regression analysis,receiver operating characteristic(ROC)curve and decision curve.Results Among the 152 patients,25 died(16.45%)and 127 survived(83.55%).The age of the poor prognosis group was greater than that of the good prognosis group,and the proportion of diabetes was higher than that of the good prognosis group(P<0.05,P<0.01).The serum albumin level in the poor prognosis group was lower than that in the good prognosis group,while the serum Lp-a level was higher than that in the good prognosis group(P<0.01).Age,diabetes,serum albumin and Lp-a remained the influencing factors for the clinical prognosis of MHD in patients with CRF(P<0.05,P<0.01).The area under the ROC curve(AUC)values of serum albumin,Lp-a alone and in combination for predicting the clinical prognosis of MHD in patients with CRF was 0.782,0.773 and 0.868,respectively.The predictive value of serum albumin combined with Lp-a was the highest.Compared with the prediction by serum albumin and Lp-a alone,the combined prediction of the two for the clinical prognosis of MHD in CRF patients had a higher net benefit rate.When the threshold was between 0.01 and 0.75,the net benefit rate was>0,and the maximum net benefit rate was 0.164.Conclusion Serum albumin and Lp-a are closely related to the clinical prognosis of MHD in CRF patients.The lower the serum albumin level and the higher the Lp-a level,the higher the risk of poor prognosis of MHD in CRF patients.关键词
慢性肾衰竭/维持性血液透析/白蛋白/脂蛋白-a/预后/危险因素/受试者工作特征Key words
chronic renal failure/maintenance hemodialysis/albumin/lipoprotein-a/prognosis/risk factors/receiver operating characteristic引用本文复制引用
丰爱梅,王素霞..血清白蛋白、脂蛋白-a与慢性肾衰竭维持性血液透析患者预后不良的相关性[J].临床误诊误治,2025,38(15):42-46,62,6.基金项目
山东省医药卫生科技发展计划项目(Q2023WN113) （Q2023WN113）
