中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (11): 586-589.doi: 10.3969/j.issn.1671-4091.2013.11.00

• 临床研究 • 上一篇    下一篇

缺血修饰白蛋白对腹膜透析患者心血管事件预测的评估

苏晓燕1,黄辉2,关晓东1,梁翔1,唐杏明1,邹原方1   

  1. 1. 中山大学附属东华医院肾内科
    2. 中山大学孙逸仙纪念医院心内科
  • 收稿日期:2013-06-13 修回日期:2013-08-17 出版日期:2013-11-12 发布日期:2013-11-12
  • 通讯作者: 苏晓燕 suxiaoyan769@hotmail.com E-mail:suxiaoyan769@hotmail.com
  • 基金资助:

    1.国家自然科学基金(项目编号：81170647) 2.东莞市科技计划医疗卫生类科研一般项目(编号：201210515000387)

Evaluation of ischemia modified albumin for cardiovascular events in patients on peritoneal dialysis

  • Received:2013-06-13 Revised:2013-08-17 Online:2013-11-12 Published:2013-11-12

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摘要： 目的：分析腹膜透析（PD）患者缺血修饰白蛋白（IMA）动态变化与主要不良心血管事件（MACE）的关系。方法：选取PD治疗超过3个月的患者78例，根据IMA水平≥85.56KU/L为高IMA组，IMA<85.56KU/L为正常IMA组，随访过程中分别于6月、12月、18月、24月重复检测IMA，并同时观察MACE的发生情况，计算无心血管事件存活率。结果：高IMA组共30例PD患者，随访24个月共发生MACE 19次；正常IMA组共48例PD患者，随访期间共发生MACE6次，两组比较有统计学意义（?2=21.91，P<0.001）。高IMA组患者入组18个月、24个月测得IMA水平较入组时明显升高（18个月：96.69±18.18 KU/L vs 86.67±19.34 KU/ L，t=2.28 P=0.03；24个月：98.03±18.56 KU/L vs 86.67±19.34 KU/L，t=2.56，P=0.01）；6月、12月、18月、24月心血管事件发生率分别为：0.77、0.60、0.43、0.37。正常IMA组患者IMA水平随访期间无明显动态变化。生存分析显示两组患者无心血管事件存活率有明显差异（Log rank检验?2=22.66，P<0.001）。结论：随访过程中，在高IMA组，伴随着IMA水平的升高，MACE发生逐渐增多。IMA可做为PD患者心血管事件的良好预测指标，有很好的临床应用价值。

关键词: 腹膜透析, 缺血修饰白蛋白, 主要不良心血管事件, 动态变化

Abstract: Objective To analysis the relationship between dynamic changes of ischemia modified albumin (IMA) and major adverse cardiovascular events (MACE) in patients on peritoneal dialysis. Methods A total of 78 end stage renal disease patients on peritoneal dialysis over 3 months were enrolled. According IMA level, they were divided into high IMA group(IMA≥85.56KU/L) and normal IMA group(IMA<85.56KU/L). IMA level was repeated measurement in 6th month、12th month、18th month, 24th month after enrollment, and MACEs were recorded, non cardiovascular events survival were calculated. Results: There were 30 patients in high IMA group, and 19 cases suffered MACE during 24 months following-up. There were 48 patients in normal IMA group, and 6 cases suffered MACE during 24 months following-up（?2=21.91，P<0.001）. In high IMA group, IMA level measured in 18th months and 24th months were significantly higher than that measured when enrolled（96.69±18.18 KU/L vs 86.67±19.34 KU/L, t=2.28 P=0.03;98.03±18.56 KU/L vs 86.67±19.34 KU/L，t=2.56，P=0.01）. Non cardiovascular events survivals calculated in 6th month、12th month、18th month、 24th month were 0.77、0.60、0.43、0.37 in high IMA group. There were no significant changes of IMA level in normal IMA group. Survival analysis showed that there were significant difference between two groups in non-MACE survival（Log rank statistic ?2=22.66，P<0.001）. Conclusions: There is an increasing trend of IMA level in high IMA group, and MACE occurs gradually increased during following-up. IMA can be used as a good predictor of peritoneal dialysis patients with MACE.

Key words: ischemia modified albumin, peritoneal dialysis, major adverse cardiovascular events, dynamic change.