重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
5期
641-643
,共3页
吴姝焜%李贵森%蒲蕾%洪大情%王君茹%王莉
吳姝焜%李貴森%蒲蕾%洪大情%王君茹%王莉
오주혼%리귀삼%포뢰%홍대정%왕군여%왕리
维持性血液透析%25(OH)维生素D%全因死亡%心血管疾病死亡
維持性血液透析%25(OH)維生素D%全因死亡%心血管疾病死亡
유지성혈액투석%25(OH)유생소D%전인사망%심혈관질병사망
maintenance hemodialysis%25(OH)D%all-cause mortality%cardiovascular mortality
目的:分析维持性血液透析(MHD)患者25(OH)维生素D[25(OH)D]水平与病死率的关系。方法收集2010年7月该院血液净化中心MHD患者156例,检测患者血25(OH)D水平,根据患者血25(OH)D水平分为3组,分别为缺乏组49例、不足组69例和正常组38例。随访时间为40个月,终点事件为全因死亡和心血管疾病死亡。结果随访40个月后,156例中死亡26例(16.7%),因心血管疾病死亡13例。缺乏组死亡15例(30.6%),其中心血管疾病死亡9例;不足组死亡8例(11.6%),其中心血管疾病死亡3例;正常组死亡3例(7.9%),其中心血管疾病死亡1例。缺乏组全因病死率及心血管疾病病死率分别与不足组和正常组比较,差异均有统计学意义(P<0.05)。Kaplan‐Meier曲线分析显示,25(OH)D≤15 ng/mL是全因和心血管疾病病死率的危险因素(P<0.05)。Cox回归分析未矫正(RR=4.43,95% CI:1.28~15.32,P<0.05)和矫正(RR=4.92,95% CI:1.23~19.66,P<0.05)年龄、性别等因素后结果均显示25(O H )D≤15 ng/m L是全因病死率的危险因素,未矫正时25(O H )D≤15 ng/mL是心血管疾病死亡率的危险因素(RR=8.12,95% CI:1.04~64.15,P=0.047)。结论 MHD患者25(OH)D水平普遍偏低,25(OH)D≤15 ng/mL为MHD患者全因和心血管疾病病死率的危险因素。
目的:分析維持性血液透析(MHD)患者25(OH)維生素D[25(OH)D]水平與病死率的關繫。方法收集2010年7月該院血液淨化中心MHD患者156例,檢測患者血25(OH)D水平,根據患者血25(OH)D水平分為3組,分彆為缺乏組49例、不足組69例和正常組38例。隨訪時間為40箇月,終點事件為全因死亡和心血管疾病死亡。結果隨訪40箇月後,156例中死亡26例(16.7%),因心血管疾病死亡13例。缺乏組死亡15例(30.6%),其中心血管疾病死亡9例;不足組死亡8例(11.6%),其中心血管疾病死亡3例;正常組死亡3例(7.9%),其中心血管疾病死亡1例。缺乏組全因病死率及心血管疾病病死率分彆與不足組和正常組比較,差異均有統計學意義(P<0.05)。Kaplan‐Meier麯線分析顯示,25(OH)D≤15 ng/mL是全因和心血管疾病病死率的危險因素(P<0.05)。Cox迴歸分析未矯正(RR=4.43,95% CI:1.28~15.32,P<0.05)和矯正(RR=4.92,95% CI:1.23~19.66,P<0.05)年齡、性彆等因素後結果均顯示25(O H )D≤15 ng/m L是全因病死率的危險因素,未矯正時25(O H )D≤15 ng/mL是心血管疾病死亡率的危險因素(RR=8.12,95% CI:1.04~64.15,P=0.047)。結論 MHD患者25(OH)D水平普遍偏低,25(OH)D≤15 ng/mL為MHD患者全因和心血管疾病病死率的危險因素。
목적:분석유지성혈액투석(MHD)환자25(OH)유생소D[25(OH)D]수평여병사솔적관계。방법수집2010년7월해원혈액정화중심MHD환자156례,검측환자혈25(OH)D수평,근거환자혈25(OH)D수평분위3조,분별위결핍조49례、불족조69례화정상조38례。수방시간위40개월,종점사건위전인사망화심혈관질병사망。결과수방40개월후,156례중사망26례(16.7%),인심혈관질병사망13례。결핍조사망15례(30.6%),기중심혈관질병사망9례;불족조사망8례(11.6%),기중심혈관질병사망3례;정상조사망3례(7.9%),기중심혈관질병사망1례。결핍조전인병사솔급심혈관질병병사솔분별여불족조화정상조비교,차이균유통계학의의(P<0.05)。Kaplan‐Meier곡선분석현시,25(OH)D≤15 ng/mL시전인화심혈관질병병사솔적위험인소(P<0.05)。Cox회귀분석미교정(RR=4.43,95% CI:1.28~15.32,P<0.05)화교정(RR=4.92,95% CI:1.23~19.66,P<0.05)년령、성별등인소후결과균현시25(O H )D≤15 ng/m L시전인병사솔적위험인소,미교정시25(O H )D≤15 ng/mL시심혈관질병사망솔적위험인소(RR=8.12,95% CI:1.04~64.15,P=0.047)。결론 MHD환자25(OH)D수평보편편저,25(OH)D≤15 ng/mL위MHD환자전인화심혈관질병병사솔적위험인소。
Objective To analyze the relationship between the level of 25 (OH )D and mortality in maintenance hemodialysis (M HD) patients .Methods This study was a prospective cohort study .We enrolled 156 M HD patients of Sichuan people′s hospital dialysis center in July of 2010 .The patients were divided into three groups according to the level of 25(OH)D .The three groups were normal(25(OH)D>30 ng/mL) ,insufficient(15 ng/mL<25(OH)D≤30 ng/mL) and deficient(25(OH)D≤15 ng/mL) re‐spectively .All the patients were follow‐up 40 months ;the end point was all‐cause and cardiovascular death .Results After follow‐up 40 months ,there were 26 deaths (16 .7% ) and 13 cardiovascular deaths among the 156 cases .There were 15 deaths (30 .6% ) in in‐sufficient group ,among which there were nine cardiovascular deaths ;there were eight deaths (11 .6% ) in deficient group ,among which there were three cardiovascular deaths ;there were three deaths (7 .9% ) in normal group ,among which there was one cardio‐vascular death .There was statistically significance either between all‐cause and cardiovascular mortality of deficient and normal group or between deficient and insufficient group (P<0 .05) .The Kaplan‐Meier curve analysis showed 25(OH)D≤15 ng/mL was the independent risk factor of the all‐cause and cardiovascular mortality(P<0 .05) .Cox regression showed 25(OH)D≤15 ng/mL was the independent risk factor of the all‐cause mortality in crude analysis (RR=4 .43 ,95% CI:1 .28-15 .32 ,P<0 .05) and adjus‐ted analysis (RR=4 .92 ,95% CI 1 .23-19 .66 ,P<0 .05) .Cox regression showed 25(OH)D≤15 ng/mL was the risk factor of the cardiovascular mortality in crude analysis(RR=8 .12 ,95% CI:1 .04 -64 .15 ,P=0 .047) .Conclusion 25(OH)D≤15 ng/mL was the risk factor and predictor of the all‐cause and cardiovascular mortality in M HD patients .