中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (02): 95-99.doi: 10.3969/j.issn.1671-4091.2023.02.004

• 临床研究 • 上一篇    下一篇

C-反应蛋白/白蛋白比值、碱性磷酸酶/白蛋白比值与慢性肾脏病3～5期患者冠状动脉钙化的相关性研究

洪 英   朱钰钰   王德光   

  1. 230601 合肥，1安徽医科大学第二附属医院肾脏内科
  • 收稿日期:2022-07-26 修回日期:2022-12-08 出版日期:2023-02-12 发布日期:2023-02-12
  • 通讯作者: 王德光 E-mail:wangdeguang@ahmu.edu.cn
  • 基金资助:
    安徽省自然科学基金(2008085MH244)；安徽医科大学第二附属医院国家自然科学基金孵育计划项目(2020GMFY04)；安徽医科大学2020年临床与前期学科共建项目(2020lcxk022)

The relationship between C-reactive protein to albumin ratio, alkaline phosphatase to albumin ratio and coronary artery calcification in patients with chronic kidney disease at the 3~5 stage

HONG Ying, ZHU Yu-yu, WANG De-guang   

  1. Department of Nephrology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
  • Received:2022-07-26 Revised:2022-12-08 Online:2023-02-12 Published:2023-02-12
  • Contact: 230601 合肥，1安徽医科大学第二附属医院肾脏科 E-mail:wangdeguang@ahmu.edu.cn

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摘要： 目的  分析慢性肾脏病3～5期患者冠状动脉钙化(coronary artery calcification score，CAC)的危险因素，探讨C-反应蛋白/白蛋白比值(C-reactive protein to albumin ratio，CAR)、碱性磷酸酶/白蛋白比值(alkaline phosphatase-to-albumin ratio，APAR)对CAC的预测价值。 方法  采用横断面调查方法，对175例慢性肾脏病3～5期患者进行回顾性研究，根据冠状动脉钙化评分(coronary artery calcification score，CACS)，将患者分成无钙化组88例(CACS 0～10分)和钙化组87例(CACS≥11分)，分析CAR、APAR在2组间差异。应用Spearman相关性分析CAR、APAR与CAC的相关性，二元Logistic回归分析CAC的危险因素，受试者工作特征曲线探讨CAR、APAR对CAC的预测价值。 结果  175例慢性肾脏病3～5期患者中CAC总检出率为49.7%。Spearman相关性分析显示CAC与CAR(r=0.416，P＜0.001)、APAR(r=0.226，P =0.003)呈正相关。二元Logistic回归分析结果显示年龄(OR =1.047，95% CI：1.012～1.083，P =0.007)、糖尿病(OR=0.132，95% CI：0.038～0.456，P=0.001)、CAR(OR =16.332，95% CI：2.415～110.447，P =0.004)、APAR(OR=1.500，95% CI：1.043～2.155，P=0.029)是CAC的独立危险因素。受试者工作特征曲线分析示CAR、APAR预测CKD 3～5期患者发生CAC时，曲线下面积分别为0.765(95%CI：0.695～0.835，P＜0.001)、0.648(95%CI:0.567～0.730，P =0.001)。 结论  CAR和APAR水平越高，慢性肾脏病3～5期患者冠脉病变程度越重；CAR和APAR可以作为CKD 3～5期患者冠脉严重程度的预测因子。

关键词: 冠状动脉钙化, C-反应蛋白/白蛋白比值, 碱性磷酸酶/白蛋白比值, 慢性肾脏病

Abstract: Objectives  To analyze the risk factors of coronary artery calcification (CAC) in chronic kidney disease (CKD) patients at the 3~5 stage, and to investigate the value of C-reactive protein to albumin ratio (CAR) and alkaline phosphatase to albumin ratio (APAR) in the prediction of CAC.  Methods  This was a cross-sectional and retrospective study on the 175 CKD patients at 3~5 stage. According to the CAC score, the patients were divided no CAC group (CAC score 0~10, n=88), and CAC group (CAC score ≥11, n=87). The differences of CAR and APAR were analyzed between the two groups. Spearman correlation was used to analyze the correlation between CAR, APAR and CAC. Binary logistic regression was used to analyze the risk factors of CAC. The receiver operating characteristic (ROC) curve was used to explore the values of CAR and APAR in the prediction of CAC.  Results  The detection rate of CAC was 49.7% in the 175 CKD patients at 3~5 stage. Spearman correlation analysis showed that CAC was positively correlated with CAR (r=0.416,     P<0.001) and APAR (r=0.226, P=0.003). Binary logistic regression analysis showed that age (OR=1.047, 95% CI: 1.012~1.083, P=0.007), diabetes (OR=0.132, 95% CI: 0.038~0.456, P=0.001), CAR(OR=16.332, 95% CI:2.415~110.447, P=0.004), and APAR (OR=1.500, 95% CI: 1.043~2.155, P=0.029) were the independent risk factors for CAC. ROC curve showed that the area under the curve were 0.765 (95% CI: 0.695~0.835, P<0.001) and 0.648 (95% CI: 25 0.567~0.730, P=0.001) for the prediction of CAC by CAR and APAR respectively.  Conclusion  ①The higher the values of CAR and APAR, the heavier the severity of coronary artery disease in the CKD patients at 3~5 stage. ②CAR and APAR can be used as the predictors for the severity of coronary artery disease in CKD patients at 3~5 stage.

Key words: Coronary artery calcification, C-reactive protein to albumin ratio, Alkaline phosphatase to albumin ratio, Chronic kidney disease

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