中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (08): 596-600.doi: 10.3969/j.issn.1671-4091.2024.08.005

• 临床研究 • 上一篇    下一篇

维持性腹膜透析患者外周血双特异性磷酸酶6预测全因死亡及心血管事件死亡的临床研究

郭宝珠   刘俊芬   韩小丽   李雅琪    田晓敏    靳 鑫    卫志锋    刘圣君   

  1. 075000 张家口，河北北方学院附属第一医院1肾内科 2慢病管理科
  • 收稿日期:2024-01-17 修回日期:2024-06-03 出版日期:2024-08-12 发布日期:2024-08-12
  • 通讯作者: 卫志锋 E-mail:13393248921@163.com
  • 基金资助:
    河北省医学科学研究课题(20231411)； 张家口市重点研发计划项目(2221090D)

Clinical study of Dusp6 in peripheral blood to predict all-cause death and cardiovascular event death in maintenance peritoneal dialysis patients

GUO Bao-zhu, LIU Jun-fen, HAN Xiao-li, LI Ya-qi, TIAN Xiao-min, JIN Xin, WEI Zhi-feng, LIU Sheng-jun   

  1. Department of Nephrology and 2Department of Chronic Disease Management, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2024-01-17 Revised:2024-06-03 Online:2024-08-12 Published:2024-08-12
  • Contact: 075000 张家口，河北北方学院附属第一医院1肾内科 E-mail:13393248921@163.com

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摘要： 目的  研究外周血双特异性磷酸酶6(dual-specificity phosphatase 6，Dusp6)联合临床参数对维持性腹膜透析患者全因死亡及心血管事件死亡的预测价值。 方法  选择行腹膜透析置管并开始进行持续性腹膜透析的患者进行前瞻性队列研究，检测外周血Dusp6水平并收集基线临床资料，随访全因死亡和心血管事件死亡。采用Kaplan-Meier法比较不同Dusp6水平患者的死亡率，采用COX回归模型分析全因死亡和心血管事件死亡的影响因素，采用ROC曲线分析全因死亡和心血管事件死亡的预测指标。 结果 共纳入138例患者，随访时间19(15，23)月；外周血Dusp6水平的中位数为38.9 pg/ml，外周血Dusp6≥38.9 pg/ml患者的全因死亡率和心血管事件死亡率均高于Dusp6＜38.9 pg/ml(χ2=17.500，   P＜0.001，χ2=10.560,P=0.001)；年龄、低密度脂蛋白胆固醇、C反应蛋白、Dusp6水平是患者全因死亡的影响因素(HR =1.104、3.105、21.929、1.075，95% CI：1.021～1.193、1.069～9.013、6.280～76.575、1.008～1.147，P=0.013、0.037、＜0.001、0.028)，4项指标联合预测全因死亡的灵敏度为81.11%、特异度为80.17%；年龄、尿酸、C反应蛋白、Dusp6水平是患者心血管事件死亡的影响因素(HR=1.095、2.985、4.646、1.105，95% CI：1.003～1.195、1.219～8.938、1.597～13.517、1.003～1.184，P=0.042、0.032、0.005、0.004)，4项指标联合预测心血管事件死亡的灵敏度为81.25%、特异度为80.77%。 结论  外周血Dusp6高表达与维持性腹膜透析患者全因死亡及心血管事件死亡有关，Dusp6与不同临床参数联合对全因死亡及心血管事件死亡具有一定预测价值。

关键词: 维持性腹膜透析, 双特异性磷酸酶6, 全因死亡, 心血管事件死亡, 影响因素, 预测

Abstract: Objective  To investigate dual-specificity phosphatase 6 (Dusp6) in peripheral blood combined with clinical parameters to predict all-cause death and cardiovascular event death in maintenance peritoneal dialysis (PD) patients.  Methods  Patients who underwent PD catheterization and maintenance PD were selected for the single-center and prospective cohort study. Dusp6 in peripheral blood was measured. Baseline clinical data, all-cause death and cardiovascular event death were collected. Kaplan-Meier method was used to compare the mortality of PD patients with different levels of Dusp6. Cox regression model was used to analyze the influencing factors for all-cause death and cardiovascular event death. ROC curve was used to evaluate the predictive indicators for all-cause death and cardiovascular event death.   Results  A total of 138 PD patients were included and followed up for 19 (15, 23) month. There were 48 all-cause death cases (34.78%) and 26 cardiovascular death cases (18.84%). The median level of Dusp6 in peripheral blood was 38.9pg/ml. The all-cause mortality and cardiovascular event mortality in patients with peripheral blood Dusp6 ≥38.9pg/ml were higher than in those with Dusp6 ＜38.9 pg/ml (χ²=17.5, P＜0.001; χ²=10.56, P=0.001). Age, low density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) and Dusp6 were the influencing factors for all-cause death (HR=1.104, 3.105, 21.929 and 1.075 respectively; 95% CI:1.021～1.193, 1.069～9.013, 6.280～76.575 and 1.008～1.147 respectively; P=0.013, 0.037, ＜0.001 and 0.028 respectively); when combined the 4 influencing factors to predict all-cause death, the sensitivity and specificity were 81.11% and 80.17% respectively. Age, uric acid, CRP and Dusp6 were the influencing factors for cardiovascular event death; when combined the 4 influencing factors to predict cardiovascular event death, the sensitivity and specificity were 81.25% and 80.77% respectively.  Conclusion  The high expression of Dusp6 in peripheral blood is associated with all-cause death and cardiovascular event death in PD patients. The combination of Dusp6 and other related clinical parameters has better predictive values for all-cause death and cardiovascular event death in PD patients.

Key words: Maintenance peritoneal dialysis, Dual-specificity phosphatase 6, All-cause death, Cardiovascular event death, Influencing factor, Prediction

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