中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (12): 906-909,933.doi: 10.3969/j.issn.1671-4091.2024.12.005

• 临床研究 • 上一篇    下一篇

超敏C反应蛋白与白蛋白比值与维持性血液透析患者腹主动脉钙化及全因死亡的关系

苏凯杰   曹倩颖    李忠心   

  1. 101149 北京，1首都医科大学附属北京潞河医院肾病中心
  • 收稿日期:2024-05-13 修回日期:2024-07-09 出版日期:2024-12-12 发布日期:2024-12-12
  • 通讯作者: 李忠心 E-mail:lhyy6806@ccmu.edu.cn

Correlation between hypersensitive C reactive protein to albumin ratio and abdominal aortic calcification and all-cause death in maintenance hemodialysis patients

SU Kai-jie，CAO Qian-ying，LI Zhong-xin   

  1. Department of Nephrology，Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101149, China
  • Received:2024-05-13 Revised:2024-07-09 Online:2024-12-12 Published:2024-12-12
  • Contact: 101149 北京，1首都医科大学附属北京潞河医院肾病中心 E-mail:lhyy6806@ccmu.edu.cn

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摘要： 目的 探讨超敏C反应蛋白与白蛋白比值(hypersensitive C reactive protein to albumin ratio,CAR)与维持性血液透析 (maintenance hemodialysis，MHD)患者腹主动脉钙化及全因死亡的相关性。 方法 选择2023年1月─2024年2月在首都医科大学附属北京潞河医院血液净化中心进行治疗的MHD患者为研究对象。收集符合纳入标准的患者的基本信息、规律透析治疗3个月后的生化指标、腹主动脉钙化及全因死亡情况。分析CAR与腹主动脉钙化的相关性，采用受试者工作曲线(ROC)分析CAR对腹主动脉钙化的诊断价值，采用Logistic回归分析CAR与全因死亡的关系。 结果 共纳入204例患者，其中腹主动脉钙化患者155例(75.98%)，死亡患者11例(5.39%)。腹主动脉钙化组患者CAR高于非钙化组(Z=3.105,P=0.002)。Spearman相关性分析显示CAR与腹主动脉钙化呈正相关(r=0.218,P=0.002)。CAR诊断腹主动脉钙化的cutoff值为0.02 mg/g，敏感性为92.9%，特异性为36.7%，曲线下面积为0.647(95% CI：0.554～0.741，P=0.002)。Logistic回归分析显示年龄、透析龄、HbAlc是腹主动脉钙化的独立危险因素(OR=1.074、1.015、1.881，95%CI：1.040～1.110、1.007～1.024、1.188～2.978，P＜0.001、    ＜0.001、0.001)，CAR是全因死亡的独立危险因素(OR=5.393，95% CI：1.089～26.699，P=0.039)。 结论 CAR与腹主动脉钙化呈正相关，CAR有助于腹主动脉钙化的诊断，且CAR是全因死亡的独立危险因素。

关键词: 超敏C反应蛋白与白蛋白比值, 维持性血液透析, 腹主动脉钙化, 全因死亡

Abstract: Objective  To explore the relationship between high sensitivity C reactive protein to albumin ratio (CAR) and abdominal aortic calcification and all-cause death in patients with maintenance hemodialysis (MHD).  Methods  Patients with MHD who were treated in the Blood Purification Center of Beijing Luhe Hospital affiliated to Capital Medical University from January 2023 to February 2024 were selected. The basic information and laboratory data after 3 months of regular dialysis treatment were collected in the enrolled patients, as well as the data of abdominal aortic calcification and all-cause death. The correlation between CAR and abdominal aortic calcification was analyzed. The diagnostic value of CAR for calcification was analyzed by receiver operating characteristic curve (ROC), and the relationship between CAR and all-cause death was analyzed by logistic regression.  Results  A total of 204 patients were enrolled, including 155 patients (75.98%) with abdominal aortic calcification, and 11 patients (5.39%) with death. CAR in abdominal aorta calcification group was significantly higher than that in non-calcification group (Z=3.105, P=0.002), spearman correlation analysis showed that CAR was positively correlated with abdominal aorta calcification (r=0.218, P=0.002). The CAR cutoff value was 0.02mg/g for abdominal aorta calcification, the sensitivity and specificity were 92.9% and 36.7%, respectively, with an area under the curve of 0.647 (95% CI: 0.554～0.741, P=0.002). Logistic regression analysis showed that age, dialysis age and HbAlc were independent risk factors for abdominal aortic calcification (OR=1.074, 1.015, 1.881; 95% CI:1.040～1.110, 1.007～1.024, 1.188～2.978; P＜0.001, ＜0.001, =0.001) , and that CAR was an independent risk factor for all-cause death (OR=5.393, 95% CI:1.089～26.699, P=0.039).  Conclusion  CAR is positively correlated with abdominal aorta calcification, CAR is helpful for the diagnosis of abdominal aorta calcification, and CAR is an independent risk factor for all-cause death.

Key words: Hypersensitive C reactive protein to albumin ratio, Maintenance hemodialysis, Abdominal aortic calcification, All-cause death

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