CAJ | 학술논문

目的探讨主动脉瓣和二尖瓣钙化发病的相关危险因素.方法对符合标准的维持性血液透析(MHD)患者(年龄≥18岁,透析龄＞6个月,排除曾因瓣膜疾病行外科手术或介入治疗者),采用超声心动图检查心脏瓣膜钙化情况.采用Logisitc回归分析丰动脉瓣和二尖瓣钙化的危险因素.结果在入选的181例(男98例,女83例)MHD患者中,94例(51.9%)主动脉瓣或二尖瓣钙化,其中主动脉瓣钙化90例(49.7%),二尖瓣钙化30例(16.6%),主动脉瓣和二尖瓣双瓣膜钙化26例(14.4%).多因素Logistic回归分析表明年龄(β=5.52,P=0.007)、透析龄(β=6.99,P=0.039)和前白蛋白(β=-12.616,P=0.004)与主动脉瓣钙化独市相关;年龄(β=0.085,P=0.05)与二尖瓣钙化呈弱正相关;透析龄(β=6.057,P=0.002)、原发性高血压病病史(β=3.054,P=0.008)、血红蛋白(β=-0.061,P=0.035)和β2微球蛋白(β=7.63,P=0.01)与二尖瓣钙化独立相关.结论 MHD患者主动脉瓣及二尖瓣钙化多发,且以主动脉瓣钙化更多见.年龄、透析龄和低前白蛋白血症是主动脉瓣钙化的危险因素,而二尖瓣钙化的危险因素包括年龄、透析龄、原发性高血压病病史、贫血和高β2微球蛋白血症.
목적 탐토주동맥판화이첨판개화발병적상관위험인소.방법 대부합표준적유지성혈액투석(MHD)환자(년령≥18세,투석령＞6개월,배제증인판막질병행외과수술혹개입치료자),채용초성심동도검사심장판막개화정황.채용Logisitc회귀분석봉동맥판화이첨판개화적위험인소.결과 재입선적181례(남98례,녀83례)MHD환자중,94례(51.9%)주동맥판혹이첨판개화,기중주동맥판개화90례(49.7%),이첨판개화30례(16.6%),주동맥판화이첨판쌍판막개화26례(14.4%).다인소Logistic회귀분석표명년령(β=5.52,P=0.007)、투석령(β=6.99,P=0.039)화전백단백(β=-12.616,P=0.004)여주동맥판개화독시상관;년령(β=0.085,P=0.05)여이첨판개화정약정상관;투석령(β=6.057,P=0.002)、원발성고혈압병병사(β=3.054,P=0.008)、혈홍단백(β=-0.061,P=0.035)화β2미구단백(β=7.63,P=0.01)여이첨판개화독립상관.결론 MHD환자주동맥판급이첨판개화다발,차이주동맥판개화경다견.년령、투석령화저전백단백혈증시주동맥판개화적위험인소,이이첨판개화적위험인소포괄년령、투석령、원발성고혈압병병사、빈혈화고β2미구단백혈증.
Objective To explore the potential risk factors for aortic and mitral valve calcification in maintenance hemodialysis(MHD)patients. Methods Patients on MHD for at least 6 months.aged≥1 8 years without history of surgery or catheter for heart valve disease were enrolled in the study.Echocardiographic examination was performed to detect the calcification.The risk factors for aortic and mitral valve calcification were analyzed by Logistic regression. Results One hundred and eighty-one MHD patients(98 men and 83 women)were enrolled in the study.Of all the patients,aortic or mitral valve calcification was found in 94 patients(5 1.9%),aortic valve calcification in 90 patients(49.7%),mitral valve calcification in 30 patients(16.6%),aortic and valve calcification in 26 patients(14.4%).Multivariate Logistic regression showed that age(β=5.52,P=0.007),dialysis duration(β=6.99,P=0.039)and pre-albumin(β=-12.616,P=0.004)were independently correlated with aortic valve calcification.Mitral valve calcification was independently correlated with dialysis duration(β=6.057,P=0.002),history of primary hypertension(β=3.054,P=0.008),hemoglobin(β=-0.061,P=0.035)and β2 microglobulin(β=7.63,P=0.01).While the correlation between mitral valve calcification and age was borderline significant(β=0.085,P=0.05).Conclusions Valve calcification is prevalent in MHD patients,and aortic valve calcification is more common than mitral valve calcification.Age,dialysis duration and low serum pre-albumin are independent risk factors for aortic valve calcification.The risk factors for mitral valve calcification include age,dialysis duration,history of primary hypertension,anemia and high serum β2 microglobulin.