纤维蛋白原-白蛋白比值与慢性肾脏病3~5期患者左心室肥厚的相关性研究

    Correlation between fibrinogen-albumin ratio and left ventricular hypertrophy in patients with chronic kidney disease stage 3-5

    • 摘要:
      目的  探讨慢性肾脏病(chronic kidney disease,CKD)3~5期患者的纤维蛋白原-白蛋白比值(fibrinogen-to-albumin ratio, FAR)水平与左心室肥厚(left ventricular hypertrophy,LVH)的关系以及LVH的相关因素分析。
      方法  横断面调查2018年7月至2020年3月在安徽医科大学第二附属医院就诊的CKD 3~5期患者181例,收集一般资料及生化指标;计算冠状动脉Agatston评分、左心室质量指数(left ventricular mass index,LVMI),将患者分为LVH组与非LVH组,进行组间比较,评估CKD患者LVH的危险因素。
      结果  (1) LVH组FAR水平较非LVH组水平更高 97.65(73.31,143.29)比84.40(67.52,107.06),P=0.003;(2) LVMI与FAR水平呈正相关(r= 0.194,P=0.010);(3)高FAR水平(OR =1.012,95%CI: 1.003~1.020,P= 0.006)、高血压病史(OR = 5.348,95%CI: 1.634~17.499,P=0.006)、瓣膜钙化(OR=3.392,95%CI: 1.490~7.722,P=0.004)、冠状动脉钙化(OR=2.675,95%CI: 1.180~6.064,P=0.018)、高血尿酸水平(OR= 1.004,95%CI: 1.000~1.007,P=0.026)是CKD3~5期患者LVH的独立危险因素。FAR 预测LVH的ROC曲线下面积为0.630,P=0.003;淋巴细胞计数、血尿酸、冠状动脉钙化、瓣膜钙化、高血压、FAR联合因素预测LVH的ROC曲线下面积为0.833,P<0.001。
      结论  FAR是CKD3~5期患者LVH的独立危险因素,对CKD3~5期患者合并LVH有一定的诊断价值和预测价值。

       

      Abstract:
      Objective To explore the relationship between the level of fibrinogen-albumin ratio (FAR) and left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD) stage 3-5 and examine the related factors of LVH.
      Methods  For this cross-sectional survey, general profiles and biochemical parameters were collected from 181 patients with CKD stages 3-5 treated from July 2018 to March 2020. Coronary Agatston score and left ventricular mass index (LVMI) were calculated. They were divided into two groups of left ventricular hypertrophy (LVH) and non-hypertrophy (non-LVH) for assessing risk factors for LVH.
      Results  FAR level was higher in LVH group than non-LVH group 97.65(73.31, 143.29) vs 84.40(67.52,107.06), P=0.003; LV mass index was correlated positively with FAR level (r=0.194, P=0.010); High FAR level (OR=1.012, 95% CI: 1.003-1.020, P=0.006), history of hypertension (OR=5.348, 95%CI:1.634-17.499, P=0.006), valvular calcification (OR=3.392, 95%CI:1.490-7.722 P=0.004), coronary artery calcification (OR=2.675. 95%CI:1.180-6.064, P=0.018) and high blood uric acid level (OR=1.004, 95%CI:1.000-1.007, P=0.026) were independent risk factors for LV hypertrophy in patients with CKD stages 3-5. The area under the ROC curve for FAR prediction of LVH was 0.630 (P=0.003); lymphocyte count, blood uric acid, coronary calcification, valvular calcification, hypertension and FAR combined factors predicting the area under ROC curve for LVH was 0.833 (P<0.001).
      Conclusions  As an independent risk factor for LVH in patients with CKD stage 3-5, FAR has some diagnostic and predictive values for patients with CKD stage 3-5 complicated with LVH.

       

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