中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2015年
4期
256-260
,共5页
吴桂艳%刘阳%邬明阳%孙洪芹%李金芝%李金玲%吴虹娟
吳桂豔%劉暘%鄔明暘%孫洪芹%李金芝%李金玲%吳虹娟
오계염%류양%오명양%손홍근%리금지%리금령%오홍연
腹膜透析%脑缺血%心肌缺血%内皮功能障碍
腹膜透析%腦缺血%心肌缺血%內皮功能障礙
복막투석%뇌결혈%심기결혈%내피공능장애
Peritoneal dialysis%Brain ischemia%Myocardial ischemia%Endothelial dysfunction
目的 探讨血管内皮功能障碍对腹膜透析(PD)患者主要不良心脑血管事件(MACCE)的预测价值.方法 前瞻性队列研究,以2009年1月1日至2011年12月31日期间行腹膜透析的136例终末期肾病患者为研究对象.内皮功能指标采用超声测量的肱动脉血流介导的舒张功能(FMD),随访以电话随访为主,辅以住院随访、门诊随访.生存率估算应用Kaplan-Meier法,组间生存率比较采用log-rank检验,应用多变量Cox比例风险回归分析MACCE的独立危险因素.结果 在随访期内,低FMD (FMD≤2.7％)组有18例出现MACCE,高FMD(FMD＞ 2.7％)组有13例出现MACCE.Kaplan-Meier曲线表明,与高FMD组相比,低FMD组无MACCE生存率显著下降(x2=4.190,P=0.041).多变量Cox比例风险回归分析发现总胆固醇较高、FMD较低、PD时间较长和hs-CRP较高是MACCE的独立预测因素.结论 肱动脉FMD降低是PD患者发生MACCE的独立危险因素,应用FMD有助于对PD患者行心脑血管疾病风险分层.
目的 探討血管內皮功能障礙對腹膜透析(PD)患者主要不良心腦血管事件(MACCE)的預測價值.方法 前瞻性隊列研究,以2009年1月1日至2011年12月31日期間行腹膜透析的136例終末期腎病患者為研究對象.內皮功能指標採用超聲測量的肱動脈血流介導的舒張功能(FMD),隨訪以電話隨訪為主,輔以住院隨訪、門診隨訪.生存率估算應用Kaplan-Meier法,組間生存率比較採用log-rank檢驗,應用多變量Cox比例風險迴歸分析MACCE的獨立危險因素.結果 在隨訪期內,低FMD (FMD≤2.7％)組有18例齣現MACCE,高FMD(FMD＞ 2.7％)組有13例齣現MACCE.Kaplan-Meier麯線錶明,與高FMD組相比,低FMD組無MACCE生存率顯著下降(x2=4.190,P=0.041).多變量Cox比例風險迴歸分析髮現總膽固醇較高、FMD較低、PD時間較長和hs-CRP較高是MACCE的獨立預測因素.結論 肱動脈FMD降低是PD患者髮生MACCE的獨立危險因素,應用FMD有助于對PD患者行心腦血管疾病風險分層.
목적 탐토혈관내피공능장애대복막투석(PD)환자주요불양심뇌혈관사건(MACCE)적예측개치.방법 전첨성대렬연구,이2009년1월1일지2011년12월31일기간행복막투석적136례종말기신병환자위연구대상.내피공능지표채용초성측량적굉동맥혈류개도적서장공능(FMD),수방이전화수방위주,보이주원수방、문진수방.생존솔고산응용Kaplan-Meier법,조간생존솔비교채용log-rank검험,응용다변량Cox비례풍험회귀분석MACCE적독립위험인소.결과 재수방기내,저FMD (FMD≤2.7％)조유18례출현MACCE,고FMD(FMD＞ 2.7％)조유13례출현MACCE.Kaplan-Meier곡선표명,여고FMD조상비,저FMD조무MACCE생존솔현저하강(x2=4.190,P=0.041).다변량Cox비례풍험회귀분석발현총담고순교고、FMD교저、PD시간교장화hs-CRP교고시MACCE적독립예측인소.결론 굉동맥FMD강저시PD환자발생MACCE적독립위험인소,응용FMD유조우대PD환자행심뇌혈관질병풍험분층.
Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.
