联合应用因子分析和聚类分析预测血液透析患者发生肺动脉高压的危险因素

    Prediction of risk factors in hemodialysis patients with pulmonary hypertension: combined application of factorial and cluster analyses

    • 摘要: 目的 寻找血液透析患者肺动脉高压的危险因素。方法 回顾性分析赣南医学院第一附属医院肾内科住院的91例血液透析并肺动脉高压患者的临床资料。采用因子分析联合聚类分析的方法,分析血液透析患者肺动脉高压的危险因素。结果 运用因子分析法从15个指标中提取了11个互不相关的公因子,这11个公因子代表原始指标的90.32%的信息。通过旋转后,可反映血液透析肺动脉并高压患者的年龄、性别、贫血状态、蛋白质代谢、类脂代谢、肾功能、炎症及纤溶状态、营养状态、甲状旁腺激素水平等。然后运用聚类分析的方法,将其结果分为4类,分别为男性约60岁以下、男性大于等于60岁、女性60岁以下、女性大于等于60岁。其分别都存在不同程度的贫血,其血浆纤维蛋白原均存在不同程度的偏高,血液透析并肺动脉高压患者中男性明显多于女性患者,且60岁以后发病患者数显著增加。同时,对类别2、3、4中的大多数患者铁蛋白水平升高、血磷偏高、甲状旁腺激素水平也升高明显。结论 贫血及血浆纤维蛋白原偏高是血液透析患者肺动脉高压发病的重要因素。年龄及性别可能是该类疾病发生的危险因素。铁蛋白、血磷、甲状旁腺激素或许是血液透析患者肺动脉高压的危险因素。

       

      Abstract: Objective To explore the risk factors of pulmonary hypertension (PH)in hemodialysis.Methods Retrospective analysis was performed for clinical data of 91 patients with hemodialysis PH.And factorial and cluster analyses were conducted for examining the risk factors of PH in hemodialysis.Results Eleven unrelated common factors were extracted from 15 parameters by factor analysis.These 11 common factors represented 90.32% of the information of original parameters.After rotation,it could reflect age,gender,anemic status,protein metabolism,lipid metabolism,renal function,inflammation & fibrinolysis status,nutritional status and parathyroid hormone level,etc.And then the results were divided into four categories by cluster analysis:male aged under 60 years,male aged above 60 years,female aged under 60 years and female aged above 60 years.There were varying degrees of anemia,plasma fibrinogen was higher in different degrees,males were significantly more than females and the number of patients aged above 60 years increased significantly.At the same time,the levels of ferritin,blood phosphorus and parathyroid hormone were higher in most patients in categories 2/3/4.Conclusions Anemia and high plasma fibrinogen are important factors in PH patients on hemodialysis.Age and gender may be risk factors.Ferritin,blood phosphorus and parathyroid hormone are potential risk factors in patients with hemodialysis PH.

       

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