中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (07): 422-424.doi: 10.3969/j.issn.1671-4091.2015.07.010

• 临床研究 • 上一篇    下一篇

心脏瓣膜钙化预测血液透析患者冠状动脉钙化的研究

徐丰博,孙懿,王银娜,程浩   

  1. 首都医科大学附属复兴医院肾内科
  • 收稿日期:2015-01-05 修回日期:2015-05-16 出版日期:2015-07-12 发布日期:2015-07-12
  • 通讯作者: 孙懿 sunyi2293@163.com E-mail:sunyi@126.com
  • 基金资助:

    西城区卫生局青年科技人才(科技新星)培养项目(XWKX2014-03)

Valvular calcification can be used to estimate the degree of coronary artery calcification in hemodialysis patients

  • Received:2015-01-05 Revised:2015-05-16 Online:2015-07-12 Published:2015-07-12

RichHTML

0

PDF

388

摘要： 【摘要】目的观察维持性血液透析(MHD)患者心脏瓣膜钙化及冠状动脉钙化情况，探讨用超声心动图检测心脏瓣膜钙化是否可以预测MHD 患者冠状动脉钙化程度。方法选取MHD 患者61 例，测定血清甲状旁腺激素(PTH)、血钙(Ca2+)、血磷(P3-)、血脂等指标。应用超声心动图检测心脏瓣膜是否存在钙化，应用64 层螺旋CT 检查冠状动脉钙化积分(CAC)情况。结果①无瓣膜钙化组CAC 中位数为524 分、一个瓣膜钙化组CAC 中位数为1006.5 分，二个瓣膜钙化组CAC 中位数为2094.5 分。②根据是否存在瓣膜钙化分组后，钙化组年龄(73.36±9.28 岁)明显大于无钙化组(61.60±14.87 岁)，钙化组CAC(1765 分)明显高于无钙化组(524 分)，P＜0.05。③低密度脂蛋白与CAC 呈正相关(r=0.308,P=0.016)。④心脏瓣膜钙化者更可能出现CAC＞1000 分(OR 值为4.995，95%可信区间0.877～28.445)。结论MHD 患者心血管钙化严重，应用超声心动图检查瓣膜钙化可以预测冠状动脉钙化程度。

关键词: 钙化积分, 瓣膜钙化, 维持性血液透析

Abstract: 【Abstract】Objective To observe valvular calcification (VC) and coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients, and to explore the possibility of VC for the diagnosis of CAC. Methods Sixty- one MHD patients were enrolled in this study. Serum phosphate, calcium and PTH were measured. Echocardiogram was used to detect VC, and multi-slice spiral CT (MSCT) was performed to assess the score of CAC. Agaston score was used for the estimation of CAC degree. Results ①The median CAC score in non-VC group, one-VC group and two-VC group were 524, 1,006.5 and 2,094.5, respectively. ②Patients’age was older in VC group (73.36±9.28 years) than in non-VC group (61.60±14.87 years). The median CAC score was 1,765 in VC group, and was 524 in non-VC group (P＜0.05). ③ Correlation analysis showed that the level of low density lipoprotein cholesterol was positively correlated with CAC score (r=0.308, P= 0.016). ④Patients with VC had a significantly greater likelihood of having a CAC score ＞1,000 (OR=4.995, 95% CI 0.877～28.445). Conclusion VC and CAC are frequently seen in MHD patients. The presence of VC detected by echocardiogram can predict the degree of CAC.

Key words: coronary artery calcification, valvular calcification, maintein hemodialysis