非透析慢性肾脏病患者动脉钙化的影响因素分析

    Analysis of influencing factors of arterial calcification in non-dialysis patients with chronic kidney disease

    • 摘要: 目的 探讨非透析慢性肾脏病(chronic kidney disease,CKD)患者动脉钙化的影响因素。方法 共收集337例在福建医科大学附属第一医院住院的非透析CKD患者临床资料,包括年龄、性别、体质量指数、血红蛋白、血白蛋白、血碱性磷酸酶、空腹血糖、血尿素氮、血肌酐、血尿酸、总胆固醇、低密度脂蛋白胆固醇、三酰甘油、高密度脂蛋白胆固醇、血钙、血磷、血镁、胱抑素C、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、全段甲状旁腺素(intact parathyroid hormone,iPTH)、24 h尿蛋白定量、C-反应蛋白(C-reactive protein,CRP)、25羟维生素D、骨钙素、骨密度(腰椎和股骨颈)。并根据胸部CT平扫分为动脉钙化组(包括主动脉钙化或冠状动脉钙化)和非动脉钙化组,对2组患者的临床资料进行统计分析。结果 本组非透析CKD患者经影像学检查提示同时具有主动脉钙化和冠状动脉钙化者共68例(占20.2%),仅有主动脉钙化或冠状动脉钙化之一者119例(占35.3%),无动脉钙化者150例(占44.5%);与无动脉钙化组患者比较,动脉钙化组患者具有年龄大、高血压和慢性肾炎病史多见,血三酰甘油、血胱抑素C、血CRP水平高,eGFR水平低,2组之间比较有统计学差异(均P<0.05)。采用Spearman直线相关分析,结果表明动脉钙化与低密度脂蛋白胆固醇、血尿素氮、血肌酐、胱抑素C、血尿酸、iPTH呈正相关,与eGFR呈负相关。Logistic回归分析表明,动脉钙化的保护因素为血红蛋白和eGFR。结论 血红蛋白水平和eGFR是非透析CKD患者动脉钙化的保护因素。

       

      Abstract: Objective To analyze the influencing factors of arterial calcification in non-dialysis patients with chronic kidney disease(CKD).Methods The 337 non-dialysis patients with CKD were enrolled. The clinical data were collected, including age, gender, body mass index(BMI), serum hemoglobin(Hb), albumin(Alb), blood alkaline phosphatase(ALP), blood urea nitrogen(BUN), serum creatinine(SCr), uric acid(UA), fasting blood glucose(FBG), total cholesterol(TCH), low density lipoprotein cholesterol(LDL-C), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), serum calcium(Ca), serum phosphorus(P), serum magnesium(Mg), serum cystatin C, estimated glomerular filtration rate(eGFR), intact parathyroid hormone (iPTH), 24-h urine protein excretion, C reactive protein(CRP), 25 hydroxy vitamin D3, N-osteocalcin(NOC), and bone mineral density(BMD) of lumbar spine and femoral neck. The patients were divided into arterial calcification (including aortic calcification or coronary artery calcification) group and no arterial calcification group according to the spiral CT of chest.Results According to the spiral CT of chest, 68 patients had aortic calcification and coronary artery calcification(20.2%), 119 patients were had aortic calcification or coronary artery calcification(35.3%), and 150 patients had no arterial calcification(44.5%). The patients in arterial calcification group was older, hypertension and chronic nephritis were more commonly seen, serum higher triglycerides(TG), Cystatin C and CRP levels were higher, and eGFR was lower than in no arterial calcification group (all P<0.05). Spearman linear analysis revealed that there was a positive correlation between arterial calcification with LDL-C, BUN, SCr, Cystatin C, UA and iPTH, while a negative correlation between arterial calcification with Alb and eGFR. Logistic regression analysis demonstrated that the protective factors of the aortic calcification were eGFR and hemoglobin, and no risk factors were found.Conclusions The patients with non-dialysis CKD have a higher incidence of arterial calcification. The eGFR and hemoglobin were the influencing factors of the arterial calcification in non-dialysis CKD patients.

       

    /

    返回文章
    返回