中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2013年
8期
589-594
,共6页
项方方%曹学森%徐少伟%沈波%邹建洲%滕杰%丁小强
項方方%曹學森%徐少偉%瀋波%鄒建洲%滕傑%丁小彊
항방방%조학삼%서소위%침파%추건주%등걸%정소강
血液透析%心血管疾病%淋巴细胞%单核细胞%病死率
血液透析%心血管疾病%淋巴細胞%單覈細胞%病死率
혈액투석%심혈관질병%림파세포%단핵세포%병사솔
Hemodialysis%Cardiovascular disease%Lymphocyte%Monocyte%Mortality
目的 探讨血液透析(血透)患者外周血白细胞计数及其分类与心血管事件(CVD)发生及一年预后的关系.方法 收集2009年3月至2011年3月期间在复旦大学上海医学院附属中山医院接受血液透析治疗的终末期肾病患者临床及血清学资料,并进行12个月的随访.采用Spearman相关和线性回归方法分析外周血白细胞及其分类与其他临床及实验室指标的相关关系.用t检验比较连续变量在CVD事件发生组和无CVD事件发生组的差异,用卡方检验比较分类变量差异.Kaplan-Meier生存分析和Cox风险比例模型分析白细胞及其分类对一年病死率的预测作用.结果 共371例血液透析患者人组.与无CVD事件发生组相比,CVD组患者淋巴细胞数显著降低[(1.17±0.38)比(1.34±0.51),P＜0.05],单核细胞数显著升高[(0.44±0.15)比(0.37±0.15),P＜0.01].淋巴细胞数升高者病死率较低(P＜0.01),单核细胞数升高者病死率较高(P＜0.01),其预测价值高于高敏C反应蛋白.结论 外周血白细胞计数与血液透析患者CVD的发生相关,淋巴细胞数降低和单核细胞数升高是血透患者1年病死率的独立危险因素.
目的 探討血液透析(血透)患者外週血白細胞計數及其分類與心血管事件(CVD)髮生及一年預後的關繫.方法 收集2009年3月至2011年3月期間在複旦大學上海醫學院附屬中山醫院接受血液透析治療的終末期腎病患者臨床及血清學資料,併進行12箇月的隨訪.採用Spearman相關和線性迴歸方法分析外週血白細胞及其分類與其他臨床及實驗室指標的相關關繫.用t檢驗比較連續變量在CVD事件髮生組和無CVD事件髮生組的差異,用卡方檢驗比較分類變量差異.Kaplan-Meier生存分析和Cox風險比例模型分析白細胞及其分類對一年病死率的預測作用.結果 共371例血液透析患者人組.與無CVD事件髮生組相比,CVD組患者淋巴細胞數顯著降低[(1.17±0.38)比(1.34±0.51),P＜0.05],單覈細胞數顯著升高[(0.44±0.15)比(0.37±0.15),P＜0.01].淋巴細胞數升高者病死率較低(P＜0.01),單覈細胞數升高者病死率較高(P＜0.01),其預測價值高于高敏C反應蛋白.結論 外週血白細胞計數與血液透析患者CVD的髮生相關,淋巴細胞數降低和單覈細胞數升高是血透患者1年病死率的獨立危險因素.
목적 탐토혈액투석(혈투)환자외주혈백세포계수급기분류여심혈관사건(CVD)발생급일년예후적관계.방법 수집2009년3월지2011년3월기간재복단대학상해의학원부속중산의원접수혈액투석치료적종말기신병환자림상급혈청학자료,병진행12개월적수방.채용Spearman상관화선성회귀방법분석외주혈백세포급기분류여기타림상급실험실지표적상관관계.용t검험비교련속변량재CVD사건발생조화무CVD사건발생조적차이,용잡방검험비교분류변량차이.Kaplan-Meier생존분석화Cox풍험비례모형분석백세포급기분류대일년병사솔적예측작용.결과 공371례혈액투석환자인조.여무CVD사건발생조상비,CVD조환자림파세포수현저강저[(1.17±0.38)비(1.34±0.51),P＜0.05],단핵세포수현저승고[(0.44±0.15)비(0.37±0.15),P＜0.01].림파세포수승고자병사솔교저(P＜0.01),단핵세포수승고자병사솔교고(P＜0.01),기예측개치고우고민C반응단백.결론 외주혈백세포계수여혈액투석환자CVD적발생상관,림파세포수강저화단핵세포수승고시혈투환자1년병사솔적독립위험인소.
Objective To investigate the association between peripheral white blood cell count including its subtypes and cardiovascular disease (CVD) incidence and one-year all-cause mortality in maintenance hemodialysis (MHD) patients.Methods A total of 371 MHD patients at Zhongshan Hospital,Fudan University between March 2009 and February,2011 were enrolled.Demographic,hematological,nutritional and inflammatory markers were obtained.All patients were followed for one year to investigate the risks for CVD event and mortality.Spearman correlation and linear regression were used to assess the relationship between white blood cell count and other laboratory parameters.Difference in categorical factors between two groups were determined with Chi-square test,Difference in continuous values between two groups were assessed with t test.Kaplan-Meier analysis and Cox proportional hazards model were applied to assess one-year mortality predictors.Results Patients with CVD event had lower lymphocyte count level (1.17±0.38 vs 1.34±0.51,P＜ 0.05) and higher monocyte count level (0.44 ± 0.15 vs 0.37 ± 0.15,P＜0.01) than those without CVD event.Cox proportional hazard regression showed that an increased lymphocyte count was associated with reduced mortality risk,95％CI:0.136-0.719,P ＜ 0.01) and that an increased monocyte count was associated with increased mortality risk,95％ CI:2.657-74.396,P＜0.01) after adjustment for hsCRP.Conclusion Decreased lymphocyte level and increased monocyte level are significantly related to CVD event and are independent predictors of increased one-year all-cause mortality risk in MHD patients.
