中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (02): 89-93.doi: 10.3969/j.issn.1671-4091.2026.02.001

• 临床研究 •    下一篇

硫酸吲哚酚与维持性血液透析患者心血管事件及住院的相关性分析

肖 坤   张 旭  丛 涛   刘 颖   王 楠   孙巧冰   赵春慧   林洪丽   

  1. 116011 大连，大连医科大学附属第一医院1 肾内科 3 心血管超声科 116044 大连，2 大连医科大学研究生院
  • 收稿日期:2025-06-25 修回日期:2025-10-30 出版日期:2026-02-12 发布日期:2026-02-02
  • 通讯作者: 林洪丽 E-mail:hllin@dmu.edu.cn
  • 基金资助:
    大连市高层次人才创新支持计划项目(2021RD01)

An analysis of the association between indoxyl sulfate and cardiovascular events and hospitalization in patients undergoing maintenance hemodialysis

XIAO Kun ZHANG Xu CONG Tao , LIU Ying , WANG Nan , SUN Qiao- bing , ZHAO Chun- hui , LIN Hong-li   

  1.  Department of Cardiovascular Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; 1 Department of Nephrology, 2 Graduate School of Dalian Medical University, Dalian 116044, China
  • Received:2025-06-25 Revised:2025-10-30 Online:2026-02-12 Published:2026-02-02
  • Contact: 116011 大连，大连医科大学附属第一医院1肾内科；116044 大连，2大连医科大学研究生院 E-mail:hllin@dmu.edu.cn

摘要： 目的 探讨硫酸吲哚酚(indoxyl sulfate，IS)对维持性血液透析(maintenance hemodialysis，MHD)患者心血管事件及住院的影响。 方法 选取2022年1月1日─5月31日大连医科大学附属第一 医院的MHD患者为研究对象，依据IS中位数43.00(29.98，60.72)mg/L将患者分为低IS组(IS＜43 mg/L) 和高IS组(IS≥43 mg/L)，比较2组间差异。随访至2025年5月31日，记录心血管事件及住院情况。Logistic回归分析影响因素。 结果 纳入137例患者，低IS组68例，高IS组69例。2组患者尿素清除指数 (Z=2.547，P=0.011)、糖尿病(χ2 =6.635，P=0.010)、残余肾功能(χ2 =4.109，P=0.043)、收缩压(Z=2.565，P= 0.010)、体质量指数(t=3.311，P =0.001)、高密度脂蛋白胆固醇(Z=1.929，P=0.05)、空腹血糖(Z=3.859， P＜0.001)、三酰甘油葡萄糖(triglyceride-glucose，TyG)指数(Z=2.680，P=0.007)、N末端脑钠肽前体 (Z=2.833，P=0.005)、IS(Z=10.100，P＜0.001)、左 心 室 舒 张 末 期 直 径(t=3.585，P＜0.001)、左 心 房 内 径 (Z=3.585，P=0.021)、室间隔厚度(Z=4.092，P＜0.001)、左心室后壁厚度(Z=4.122，P＜0.001)、左心室质 量指数(t=5.480，P＜0.001)、左心室射血分数(Z=2.517，P=0.012)、左心室整体纵向应变(t=-7.470，P＜ 0.001)比较差异有统计学意义。多因素Logistic回归分析表明：年龄(OR=1.060，95% CI：1.004～1.118， P=0.036)、高 血 压(OR=3.877，95% CI：1.180～12.737，P=0.026)、TyG 指 数(OR=6.359，95% CI：1.312～ 30.815，P=0.022)、IS(OR=1.066，95% CI：1.025～1.108，P=0.001)是 MHD 患者心血管事件的独立危险因 素；多因素Logistic回归分析表明：糖尿病(OR=6.520，95% CI：1.673～25.408，P=0.007)、IS(OR=1.059， 95% CI：1.021～1.097，P=0.002)为MHD患者住院的独立危险因素。 结论 IS是MHD患者发生心血管事件 和住院的独立危险因素。

关键词: 血液透析, 硫酸吲哚酚, 心血管事件, 住院

Abstract:

【Abstract】Objective To investigate the impact of indoxyl sulfate (IS) on cardiovascular events and hospitalizations in patients undergoing maintenance hemodialysis (MHD). Methods Patients receiving MHD at the First Affiliated Hospital of Dalian Medical University between January 1 and May 31, 2022 were enrolled. Based on the median IS level of 43.00 mg/L (interquartile range 29.98～60.72mg/L), participants were divided into a low-IS group (＜43 mg/L) and a high-IS group (≥43 mg/L). Inter-group differences were compared. Patients were followed up until May 31, 2025, during which cardiovascular events and hospitalizations were recorded. Logistic regression analysis was performed to identify associated factors. Results A total of 137 patients were included, with 68 in the low-IS group and 69 in the high-IS group. Significant inter-group differences were observed in urea clearance index (Z=2.547, P=0.011), diabetes prevalence (χ2 =6.635, P= 0.010), residual renal function (χ2 =4.109, P=0.043), systolic blood pressure (Z=2.565, P=0.010), body mass index (t=3.311, P=0.001), high-density lipoprotein cholesterol (Z=1.929, P=0.05), fasting glucose (Z=3.859, P＜0.001), triglyceride-glucose index (Z=2.680, P=0.007), N-terminal pro-brain natriuretic peptide (Z=2.833, P=0.005), IS level (Z=10.100, P＜0.001), left ventricular end-diastolic diameter (t=3.585, P＜0.001), left atrial diameter (Z=3.585, P=0.021), interventricular septal thickness (Z=4.092, P＜0.001), left ventricular posterior wall thickness (Z=4.122, P＜0.001), left ventricular mass index (t=5.480, P＜0.001), left ventricular ejection fraction (Z=2.517, P=0.012), and global longitudinal strain of the left ventricle (t=-7.470, P＜0.001). Multivariate logistic regression analysis identified age (OR=1.060, 95% CI: 1.004～1.118, P=0.036), hypertension (OR=3.877, 95% CI:1.180～12.737, P=0.026), triglyceride-glucose index (OR=6.359, 95% CI: 1.312～ 30.815, P=0.022), and IS level (OR=1.066, 95% CI: 1.025～1.108, P=0.001) as independent risk factors for cardiovascular events in MHD patients; while diabetes (OR=6.520, 95% CI:1.673～25.408, P=0.007) and IS level (OR=1.059, 95% CI: 1.021～1.097, P=0.002) were identified as independent risk factors for hospitalization. Conclusion IS level is an independent risk factor for both cardiovascular events and hospitalization in MHD patients. 

Key words: Hemodialysis, Indoxyl sulfate, Cardiovascular events, Hospitalizatio

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