中国实用内科杂志2025，Vol.45Issue(12)：1027-1033,7.DOI:10.19538/j.nk2025120105
CHADS2评分联合D-二聚体、白蛋白对腹膜透析患者全因死亡的预测价值研究
Research on the predictive value of CHADS2 score combined with D-dimer and albumin for all-cause mortality in peritoneal dialysis patients
摘要
Abstract
Objective To explore the predictive value of CHADS2 score,albumin(ALB)and D-dimer for clinical prognosis of peritoneal dialysis(PD)patients.Methods The clinical data of 481 patients who underwent PD catheterization in our hospital from January 2013 to September 2021 were retrospectively analyzed.According to the CHADS2 score,the study subjects were divided into low-grade group(CHADS2 score 0-＜2,191 cases),medium-grade group(CHADS2 score 2-＜4,244 cases)and high-grade group(CHADS2 score ≥ 4,46 cases).The Kaplan Meier method was used to calculate the overall survival and the Log Rank method was used to compare the overall survival of the three groups.Multivariate Cox regression analysis was used to identify the risk factors affecting all-cause mortality.Receiver operator characteristic(ROC)curve was used to compare the predictive value of relevant factors for all-cause mortality.Results Among the 481 PD patients,the morality group had higher age,level of D-dimer,proportion of diabetes and CHADS2 score and lower albumin level than the survival group.A total of 176 cases of all-cause mortality occurred,including 48 cases in the low-grade group(27.27％),103 cases in the medium-grade group(58.52％),and 25 cases in the high-grade group(14.20％).Kaplan Meier survival curve showed that the overall survival of patients in the high-grade group was significantly lower than that in the low-and medium-grade groups(Log rank x2=32.651,P＜0.001).After adjusting for confounding factors,multivariate Cox regression analysis showed that there was a statistically significant difference in CHADS2 score(HR=1.227,95％CI 1.066-1.412,P=0.004),D-dimer(HR=1.075,95％CI 1.040-1.111,P＜0.001),ALB(HR=0.968,95％CI 0.942-0.994,P=0.018)and age(HR=1.035,95％CI 1.022-1.049,P＜0.001).The area under the curve of CHADS2 score combined with D-dimer and ALB for predicting all-cause mortality in PD patients was 0.643(95％CI 0.592-0.694),which was higher than that of a single indicator.Conclusion CHADS2 score is an independent risk factor for all-cause mortality in PD patients.The combination of CHADS2 score with D-dimer and ALB can better predict the risk of all-cause mortality in PD patients and has certain significance forjudging the clinical prognosis.关键词
腹膜透析/CHADS2评分/D-二聚体/白蛋白/预后Key words
peritoneal dialysis/CHADS2 score/D-dimer/albumin/prognosis分类
医药卫生引用本文复制引用
王欢,杨雪,金重珍,金艳华,张德伟,张艳宁..CHADS2评分联合D-二聚体、白蛋白对腹膜透析患者全因死亡的预测价值研究[J].中国实用内科杂志,2025,45(12):1027-1033,7.基金项目
辽宁省应用基础研究计划(2023JH2/101300078) （2023JH2/101300078）
辽宁省应用基础研究计划(2022JH2/101500043) （2022JH2/101500043）
