中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (07): 341-344.doi: 10.3969/j.issn.1671-4091.2016.07.006

• 临床研究 • 上一篇    下一篇

维持性血液透析患者外周动脉疾病的危险因素分析

马艳艳,徐岩,许朕,张露   

  1. 山东省青岛市青岛大学附属医院肾内科
  • 收稿日期:2016-01-22 修回日期:2016-05-24 出版日期:2016-07-12 发布日期:2016-07-12
  • 通讯作者: 徐岩xuyanqyfy@126.com E-mail:xuyanqyfy@126.com
  • 基金资助:

    青岛市科技局(KJZD-14-27-JCH)

Prevalence and risk factors of peripheral artery disease in maintenance hemodialysis patients

  • Received:2016-01-22 Revised:2016-05-24 Online:2016-07-12 Published:2016-07-12

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摘要： 目的探究维持性血液透析患者外周动脉疾病的患病情况及危险因素。方法纳入青岛大学附属医院血液净化中心254 例维持性血液透析患者，对其进行临床资料的收集、体格检查、实验室检查及踝肱指数的测量。以任何一侧踝肱指数＜0.90 作为下肢外周动脉疾病的诊断标准。结果血液透析患者外周动脉疾病的患病率为22.04%(56/254)，男女患病率无差异。多元Logistic 回归分析显示年龄(OR 5.888，95% CI 1.822～19.029, P=0.003)，透析龄(OR 1.080，95% CI 1.035～1.127, P＜0.001)，糖尿病(OR 3.138， 95% CI 1.070～9.200，P=0.037)，低白蛋白水平(OR 12.138，95% CI3.472～24.16，P＜0.001)，尿素清除指数不达标(低于1.2) (OR 24.615，95% CI 2.235～553.415，P=0.011)，脑血管疾病(OR 13.374， 95% CI 1.338～38.654，P=0.002)，腹型肥胖(OR 7.285， 95% CI2.149～24.689，P=0.001)，高三酰甘油(OR 3.257，95% CI 1.050～10.102，P=0.041)，碱性磷酸酶(OR4.599，95% CI 1.249～16.635，P=0.022)，C-反应蛋白(OR 5.098，95% CI 1.383～18.793，P=0.014)为外周动脉疾病的独立危险因素。结论维持性血液透析患者外周血管疾病患病率较高，老年、透析龄、腹型肥胖、糖尿病、脑血管疾病史、低白蛋白水平、高三酰甘油血症、尿素清除指数不达标、碱性磷酸酶、C-反应蛋白为此人群外周血管疾病的独立危险因素。

关键词: 外周动脉疾病, 血液透析, 患病率, 危险因素

Abstract: Aim To investigate the prevalence and risk factors of peripheral artery disease (PAD) in maintenance hemodialysis patients (MHD) by ankle brachial index (ABI). Methods A total of 254 MHD were enrolled and received questionnaire, physical examinations and laboratory examinations. PAD was diagnosed when ABI＜0.9. Results The prevalence of PAD in MHD patients in our center was 22.04% (56/254) without significant difference between genders, but was higher in older aged group (>65 years) than in younger group (39% vs. 13.9%, P＜0.05). Logistic regression showed that age (OR 1.822～19.029, P=0.003), dialysis age (OR 1.035～1.127, P＜0.001), diabetes (OR, 1.070～9.200, P=0.037), low albumin level (OR 3.472～ 24.16, P＜0.001), cerebral vascular disease history (OR 1.338～38.654, P =0.002), abdominal obesity (OR 2.149～24.689, P =0.001), hypertriglyceridemia (OR 1.050～10.102, P=0.041), Kt/V (OR 2.235～553.415, P= 0.011), alkaline phosphatase (OR 1.249～16.635, P=0.022), and C-reactive protein (OR 1.383～18.793, P = 0.014) were the independent risk factors for PAD. Conclusions MHD patients of older age, longer dialysis age, diabetes, lower Kt/v, abdominal obesity, lower albumin level, higher alkaline phosphatase, increased C-reactive protein, hypertriglyceridemia, and cerebral vascular disease history had a relatively higher risk of PAD.

Key words: Peripheral Artery Diseases, Hemodialysis, Prevalence, Risk factors