• 中国科技论文统计源期刊
  • 中国科技核心期刊
  • 中国高校优秀期刊
  • 安徽省优秀科技期刊

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

维持性血液透析患者血管钙化相关因素研究

陈忠辉 ,  何静

downloadPDF
文章导航 > 蚌埠医学院学报  > 2016,  41 > 9: (1207-1210)  
引用本文:
shu
Citation:
shu

维持性血液透析患者血管钙化相关因素研究

  • 安徽省宣城市人民医院 肾内科, 242000

    • 作者简介: 陈忠辉(1980-),男,硕士,主治医师.

  • 中图分类号: R458.5

Analysis of the related factors of the angiosteosis in patients with maintenance hemodialysis

  • Department of Nephrology, The People's Hospital of Xuancheng, Xuancheng Anhui 242000, China

  • CLC number: R458.5

  • 摘要: 目的：观察维持性血液透析（MHD）患者的血管钙化情况，并分析相关检查结果，探讨影响MHD患者血管钙化的可能因素。方法：选取行MHD且透析时间>3个月的患者102例，行腹部侧位平片观察腹主动脉钙化情况，提示腹主动脉钙化为钙化组，未发现腹主动脉钙化为非钙化组。心脏及颈部血管彩超检查观察2组心脏瓣膜钙化及颈动脉内膜中层厚度（IMT），根据Kauppila法进行血管钙化评分，同时计算心血管钙化指数。并抽血检查血全段甲状旁腺激素、超敏C反应蛋白（hs-CRP）、血常规、肝肾功能、血糖、血脂、血钙、血磷、碱性磷酸酶等生化指标。结果：钙化组年龄、透析龄、血磷、是否糖尿病肾病、hs-CRP、IMT与非钙化组差异均有统计学意义（P < 0.05～P < 0.01）。相关性分析研究发现年龄、透析龄、hs-CRP、血磷和IMT与血管钙化评分均呈正相关关系（P < 0.05～P < 0.01）。logistic回归发现患者的年龄、透析龄、是否糖尿病和hs-CRP均是患者发生血管钙化的独立危险因素（P<0.01）。结论：MHD患者血管钙化现象较为常见，伴发糖尿病、高龄、长透析龄及微炎症状态可能是MHD患者血管钙化的独立危险因素。
    Abstract: Objective: To observe the vascular calcification,analyze the related examination results,and explore its possible influencing factor in patients with maintenance hemodialysis(MHD).Methods: One hundred and two MHD patients with time more than 3 months were selected,and divided into the calcification group and non-calcification group according to the abdominal aorta calcification diagnosed by lateral plain film of abdomen.The cardiac valve calcification and carotid artery intima-media thickness(IMT) in two groups were observed by the heart and neck vascular ultrasound examination.The abdominal aorta calcification score(AACs) was analyzed according to the Kauppila,and the cardiovascular calcification index was calculated in two groups.The biochemical indicators of serum intact parathyroid hormone,high sensitive C reactive protein(hs-CRP),blood routine test,liver and renal function,and blood glucose,lipid,calcium,phosphorus and alkaline phosphatase alkaline phosphatase between two groups were compared.Results: There were significant differences in the age,age of dialysis,blood phosphorus,diabetic nephropathy,hs-CRP and IMT between two groups(P<0.05 to P<0.01).The correlation analysis showed that the age,age of dialysis,blood phosphorus,hs-CRP and IMT of patients were positively correlated with AACs scores(P<0.05 to P<0.01).Logistic regression showed that the age,age of dialysis,diabetes and hs-CRP of patients were the independent risk factor of vascular calcification(P<0.01).Conclusions: The vascular calcification is more common in MHD patients,and the risk factors of vascular calcification in patients with MHD may be associated with diabetes,aging,long duration of dialysis and microinflammatory.
  • [1] 贾玉凤,徐斌,龚德华,等.维持性血液透析患者心血管钙化的发生率及分布特点[J].肾脏病与透析肾移植杂志,2014,5(23):401.
    [2] YEH HT,HUANG IJ,CHEN CM,et al.Regression of vascular calcification following an acute episode of calciphylaxis:a case report[J].J Med Case Rep,2014,8(1):52.
    [3] LIABEUF S,OKAZAKI H,DESIARDINS L,et al.Vascular calcification in chronic kidney disease:are biomarkers useful for probing the pathobiology and the health risks of this process in the clinical scenario[J].Nephrol Dial Transplant,2014,29(7):1275.
    [4] LIBEMAN M,PESARO AE,CARMO LS,et al.Vascular calcification:pathophysiology and clinical implications[J].Einstein (Sao Paulo),2013,11(3):376.
    [5] RAGGI P,BELLASI A,FERRAMOSCA E,et al.Association of Pulse wave velocity with vaular and valvular caldfication in hemodiaIysis patients[J].Kidney Int,2007,71(8):802.
    [6] PENCAK P,CZERWIENSKA B,FICEK R,et al.Calcification of coronary arteries and abdominal aorta in relation to traditional and novel risk factors of atherosclerosis in hemodialysis patients[J].BMC Nephrol,2013,14(1):10.
    [7] ABDELMALEK JA,STARK P,WALTHER CP,et al.Associations between coronary calcification on chest radiographs and mortality in hemodialysis patients[J].Am J Kidney Dis,2012,60(6):990.
    [8] DISTHABANCHONG S.Vascular calcification in chronic kidney disease:Pathogenesis and clinical implication[J].World J Nephrol,2012,1(2):43.
    [9] MCCARTY MF,DINICOLANTONIO JJ.The molecular biology and pathophysiology of vascular calcification[J].Postgrad Med,2014,126(2):54.
    [10] CROUTHAMEL MH,LAU WL,LEAF EM,et al.Sodium-dependent phosphate cotransporters and phosphate-induced calcification of vascular smooth muscle cells:redundant roles for PiT-1 and PiT-2[J].Arterioscler Thromb Vasc Biol,2013,33(11):2625.
    [11] SHROFF RC,MCNAIR R,SKEPPER JN,et al.Chronic mineral dysregulation promotes vascular smooth muscle cell adaptation and extracellular matrix calcification[J].J Am Soc Nephrol,2010,21(1):103.
    [12] LIU J,MA KL,GAO M,et al.Inflammation disrupts the LDL receptor pathway and accelerates the progression of vascular calcification in ESRD patients[J].PLoS One,2012,7(10):e47217.
    [13] KIU WEBER CI,DUCHATEAU-NGUYEN G,Solier C,et al.Cardiovascular risk markers associated with arterial calcification in patients with chronic kidney disease Stages 3 and 4[J].Clin Kidney J,2014,7(2):167.
    [14] KRASNIAK A,DROZDZ M,PASOWICZ M,et al.Factors involved in vascular calcification and atherosclerosis in maintenance haemodialysis patients[J].Nephrol Dial Transplant,2007,22(2):515.
    [15] AVOGARO A,RATTAZZI M,FADINI GP,et al.Ectopic calcification in diabetic vascular disease[J].Expert Opin Ther Targets,2014,18(5):595.
    [16] HEATH JM,SUN Y,YUAN K,BRADLEY WE,et al.Activation of AKT by O-linked N-acetylglucosamine induces vascular calcification in diabetes mellitus[J].Circ Res,2014,114(7):1094.
    [17] BRODEUR MR,BOUVET C,BOUCHARD S,et al.Reduction of advanced-glycation end products levels and inhibition of RAGE signaling decreases rat vascular calcification induced by diabetes[J].PLoS One,2014,9(1):e85922.
  • [1] 王梦慈 , 吴志茹 , 尹晓丽 , 徐鹏 , 赵雯雯 , 王妍菲 , 张继强 . FGF-21、BMP-2在维持性血液透析病人自体动静脉内瘘血管钙化中的作用. 蚌埠医学院学报, 2022, 47(4): 495-499. doi: 10.13898/j.cnki.issn.1000-2200.2022.04.017
    [2] 李斌 . 维持性血液透析患者发生心血管疾病危险因素分析. 蚌埠医学院学报, 2013, 37(8): 967-969.
    [3] 王慧 . 门诊护理管理在糖尿病合并动脉粥样硬化性心血管疾病防治中的应用. 蚌埠医学院学报, 2017, 42(6): 832-834. doi: 10.13898/j.cnki.issn.1000-2200.2017.06.044
    [4] 马艳 , 李秀梅 , 王玉芹 . 临时性血管通路在血液净化中的应用. 蚌埠医学院学报, 2007, 32(4): 457-458.
    [5] 唐冰霜 . 替米沙坦对老年糖尿病合并高血压患者胰岛素敏感性及血管内皮功能的影响. 蚌埠医学院学报, 2013, 37(7): 854-855,858.
    [6] 汪吉平 . 糖尿病肾病血液透析患者动静脉内瘘的护理. 蚌埠医学院学报, 2006, 31(4): 428-430.
    [7] 刘洋 , 汪吉平 , 骆俊秀 , 刘丽 . 钝针扣眼穿刺在糖尿病肾病维持性血液透析病人中的应用效果. 蚌埠医学院学报, 2018, 43(7): 947-949. doi: 10.13898/j.cnki.issn.1000-2200.2018.07.031
    [8] 杨玮 . 肥胖2型糖尿病患者代谢异常及心脑血管并发症分析. 蚌埠医学院学报, 2013, 37(12): 1593-1595.
    [9] 房振宇 , 刘永梅 . 维持性血液透析病人透析中血压变异性与慢性肾脏病-矿物质和骨异常的相关性研究. 蚌埠医学院学报, 2017, 42(12): 1652-1653. doi: 10.13898/j.cnki.issn.1000-2200.2017.12.025
    [10] 苏真 , 陈建梅 . 左卡尼汀对糖尿病肾病透析病人炎性因子与红细胞免疫的影响. 蚌埠医学院学报, 2017, 42(10): 1349-1352. doi: 10.13898/j.cnki.issn.1000-2200.2017.10.017
    [11] 王媛媛 , 谢虹 . 血糖指数、血糖负荷在2型糖尿病饮食教育中的应用进展. 蚌埠医学院学报, 2015, 40(2): 272-275. doi: 10.13898/j.cnki.issn.1000-2200.2015.02.048
    [12] 刘畅 , 张凯 , 徐锦程 , 吴志刚 , 杨东昆 , 胡凯 . 颌面部游离组织瓣移植术后血管危象发生的危险因素分析. 蚌埠医学院学报, 2020, 45(10): 1414-1416. doi: 10.13898/j.cnki.issn.1000-2200.2020.10.026
    [13] 倪龙根 . 丙型肝炎病毒感染与血液透析的关系. 蚌埠医学院学报, 2004, 29(1): 92-94.
    [14] 索文丽 . 老年尿毒症患者血液透析护理体会. 蚌埠医学院学报, 2009, 34(5): 438-440.
    [15] 李彩 . 血液透析护理体会(附20例报道). 蚌埠医学院学报, 2008, 33(4): 486-487.
    [16] 周锡芳 . 血液透析室医院感染18例护理体会. 蚌埠医学院学报, 2011, 36(11): 1279-1281.
    [17] 高潮清 , 周加军 . 血液透析与腹膜透析对尿毒症病人钙磷代谢的影响比较. 蚌埠医学院学报, 2017, 42(4): 472-473,476. doi: 10.13898/j.cnki.issn.1000-2200.2017.04.016
    [18] 汪睿 , 吴坚 . 糖尿病足溃疡危险因素分析. 蚌埠医学院学报, 2015, 40(11): 1496-1500. doi: 10.13898/j.cnki.issn.1000-2200.2015.11.011
    [19] 马胜银 , 郝丽 , 刘朝阳 , 刘莉华 . 左旋肉碱对尿毒症血液透析患者贫血的改善作用. 蚌埠医学院学报, 2007, 32(1): 73-74.
    [20] 徐文蔚 , 毛佩菊 , 刘欣颖 . 血液透析患者瘦素水平与胰岛素抵抗的关系研究. 蚌埠医学院学报, 2009, 34(5): 392-394.
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  3638
  • HTML全文浏览量:  498
  • PDF下载量:  123
  • 被引次数: 0
出版历程
  • 收稿日期:  2015-03-15

维持性血液透析患者血管钙化相关因素研究

    作者简介: 陈忠辉(1980-),男,硕士,主治医师.
  • 安徽省宣城市人民医院 肾内科, 242000
  • 收稿日期: 2015-03-15

摘要: 目的：观察维持性血液透析（MHD）患者的血管钙化情况，并分析相关检查结果，探讨影响MHD患者血管钙化的可能因素。方法：选取行MHD且透析时间>3个月的患者102例，行腹部侧位平片观察腹主动脉钙化情况，提示腹主动脉钙化为钙化组，未发现腹主动脉钙化为非钙化组。心脏及颈部血管彩超检查观察2组心脏瓣膜钙化及颈动脉内膜中层厚度（IMT），根据Kauppila法进行血管钙化评分，同时计算心血管钙化指数。并抽血检查血全段甲状旁腺激素、超敏C反应蛋白（hs-CRP）、血常规、肝肾功能、血糖、血脂、血钙、血磷、碱性磷酸酶等生化指标。结果：钙化组年龄、透析龄、血磷、是否糖尿病肾病、hs-CRP、IMT与非钙化组差异均有统计学意义（P < 0.05～P < 0.01）。相关性分析研究发现年龄、透析龄、hs-CRP、血磷和IMT与血管钙化评分均呈正相关关系（P < 0.05～P < 0.01）。logistic回归发现患者的年龄、透析龄、是否糖尿病和hs-CRP均是患者发生血管钙化的独立危险因素（P<0.01）。结论：MHD患者血管钙化现象较为常见，伴发糖尿病、高龄、长透析龄及微炎症状态可能是MHD患者血管钙化的独立危险因素。

English Abstract

    全文HTML

参考文献 (17)

目录

    /

    返回文章
    返回

    版权所有© 2019《蚌埠医学院学报》编辑部 皖ICP备06000434号-1

    地址：安徽省蚌埠市东海大道2600号 邮编：233030

    电话：0552-3175456 Email：byxb@vip.163.com

    本系统由 北京仁和汇智信息技术有限公司 开发 技术支持： info@rhhz.net   百度统计