中国血液净化

›› 2010, Vol. 9 ›› Issue (5): 247-250.

• 临床研究 • 上一篇    下一篇

血液透析患者长期生存与冠状动脉钙化积分的关系

李文歌 卞维静 张 凌 傅芳婷 吕 滨

  

  1. 卫生部中日友好医院肾内科， 中国医学科学院阜外心血管病医院放射科
  • 收稿日期:2010-03-18 修回日期:1900-01-01 出版日期:2010-05-12 发布日期:2010-05-12
  • 通讯作者: 张凌

Impact of coronary artery calcification score measured with electron beam computed tomography on cardiovascular disease and its mortality in hemodialysis patients

LI Wen-ge, BIAN Wei-jing, ZHANG Ling, FU Fang-ting, LV Bin   

  1. 1Departerment of Nephrology, China-Japan Friendship Hospital, Beijing 100029; 2Department of Radiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China
  • Received:2010-03-18 Revised:1900-01-01 Online:2010-05-12 Published:2010-05-12

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摘要：

【摘要】 目的 长期随访冠状动脉钙化积分(coronary artery calcification score,CACS)与维持性血液透析(maintain hemodialysis,MHD)患者心血管疾病(cardiavascular disease,CVD)的发生与死亡的关系。方法 通过追踪随访电子束CT(electron beam computed tomography,EBCT)测定CACS的MHD患者22例，在2002年至2009年期间CVD的发生及其死亡情况，分析CACS与CVD的关系，通过Kaplan-Meier生存曲线比较CACS≥100分组和CACS＜100分组的平均生存率。结果 在2002年，22例患者中的21例(95.5%)存在不同程度的血管钙化(CACS＞0分)，CACS平均为1935.54分(0～9833分)。随访至2009年12月31日，17例发生过CVD(81.0%)；14例死亡(66.7%)，全部死于CVD相关疾病。在CACS≥100分组，15例患者中有14例发生CVD(93.3%)，12例死亡(80.0%)；其显著高于CACS＜100分组的CVD发生率(50.0%，3/6)和死亡率(33.3%，2/6)，差异均有统计学意义(P＜0.05)。CACS≥100分组与＜100分组比较，hs-CRP分别为(0.006±0.005)g/L和(0.002±0.002)g/L,Alb分别为(38.00±1.56)g/L和(42.00±3.79)g/L，差异均有统计学意义(P＜0.05)。Kaplan-Meier生存曲线显示CACS≥100分组的平均生存时间111.3个月，CACS＜100分组的平均生存时间222.7个月，两者之间有显著性差异(P = 0.042)。 结论 CACS与MHD患者CVD的发生和死亡相关，微炎症和营养不良可能是重要的风险因素，CACS〈100分组生存时间明显长于CACS≥100分组。

关键词: 血管钙化, 心血管疾病, 死亡率, 血液透析

Abstract:

【Abstract】 Objective To investigate correlation of coronary artery calcification score (CACS) with morbidity and mortality of cardiovascular disease (CVD) in hemodialysis patients. Methods Twenty-two patients undergoing maintain hemodialysis (MHD) were enrolled. CACS was determined by electron beam computed tomography (EBCT) in 2002. At 2009-12-31, the relationship of CACS to morbidity and mortality of CVD was analyzed retrospectively. Results In 2002, there were twenty-one patients (95.5%) with coronary artery calcification (CACS＞0). The mean CACS was 1935.54 (0~9833). During a Follow-up period of 7 years, CVD occurred in 17 cases (81.0%) of 21 Patients, and there were 14 deaths (66.7%), of which all was from disease correlated with CVD. Patients with CACS=100 had significantly higher morbidity and mortality of CVD than patients with CACS＜100. High level of hs-CRP and low Alb in group of CACS=100 than CACS<100(P＜0.05). Kaplan-Meier curve demonstrated the average survival time in group of CACS＜100 was longer than group of CACS=100（222.7 vs 111.3M,P=0.042）. Conclusions CACS is correlated with morbidity and mortality of CVD in hemodialysis patients. Microinflammation and malnutrition are important factors. The survival time in group of CACS＜100 was longer than group of CACS≥100.

Key words: Cardiovascular disease, Mortaility, Hemodialysis