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临床研究

维持性血液透析患者外周动脉疾病的危险因素分析

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  • 山东省青岛市青岛大学附属医院肾内科

收稿日期: 2016-01-22

  修回日期: 2016-05-24

  网络出版日期: 2016-07-12

基金资助

青岛市科技局(KJZD-14-27-JCH)

Prevalence and risk factors of peripheral artery disease in maintenance hemodialysis patients

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Received date: 2016-01-22

  Revised date: 2016-05-24

  Online published: 2016-07-12

摘要

目的探究维持性血液透析患者外周动脉疾病的患病情况及危险因素。方法纳入青岛大学附属医院血液净化中心254 例维持性血液透析患者,对其进行临床资料的收集、体格检查、实验室检查及踝肱指数的测量。以任何一侧踝肱指数<0.90 作为下肢外周动脉疾病的诊断标准。结果血液透析患者外周动脉疾病的患病率为22.04%(56/254),男女患病率无差异。多元Logistic 回归分析显示年龄(OR 5.888,95% CI 1.822~19.029, P=0.003),透析龄(OR 1.080,95% CI 1.035~1.127, P<0.001),糖尿病(OR 3.138, 95% CI 1.070~9.200,P=0.037),低白蛋白水平(OR 12.138,95% CI3.472~24.16,P<0.001),尿素清除指数不达标(低于1.2) (OR 24.615,95% CI 2.235~553.415,P=0.011),脑血管疾病(OR 13.374, 95% CI 1.338~38.654,P=0.002),腹型肥胖(OR 7.285, 95% CI2.149~24.689,P=0.001),高三酰甘油(OR 3.257,95% CI 1.050~10.102,P=0.041),碱性磷酸酶(OR4.599,95% CI 1.249~16.635,P=0.022),C-反应蛋白(OR 5.098,95% CI 1.383~18.793,P=0.014)为外周动脉疾病的独立危险因素。结论维持性血液透析患者外周血管疾病患病率较高,老年、透析龄、腹型肥胖、糖尿病、脑血管疾病史、低白蛋白水平、高三酰甘油血症、尿素清除指数不达标、碱性磷酸酶、C-反应蛋白为此人群外周血管疾病的独立危险因素。

本文引用格式

马艳艳,徐岩,许朕,张露 . 维持性血液透析患者外周动脉疾病的危险因素分析[J]. 中国血液净化, 2016 , 15(07) : 341 -344 . DOI: 10.3969/j.issn.1671-4091.2016.07.006

Abstract

Aim To investigate the prevalence and risk factors of peripheral artery disease (PAD) in maintenance hemodialysis patients (MHD) by ankle brachial index (ABI). Methods A total of 254 MHD were enrolled and received questionnaire, physical examinations and laboratory examinations. PAD was diagnosed when ABI<0.9. Results The prevalence of PAD in MHD patients in our center was 22.04% (56/254) without significant difference between genders, but was higher in older aged group (>65 years) than in younger group (39% vs. 13.9%, P<0.05). Logistic regression showed that age (OR 1.822~19.029, P=0.003), dialysis age (OR 1.035~1.127, P<0.001), diabetes (OR, 1.070~9.200, P=0.037), low albumin level (OR 3.472~ 24.16, P<0.001), cerebral vascular disease history (OR 1.338~38.654, P =0.002), abdominal obesity (OR 2.149~24.689, P =0.001), hypertriglyceridemia (OR 1.050~10.102, P=0.041), Kt/V (OR 2.235~553.415, P= 0.011), alkaline phosphatase (OR 1.249~16.635, P=0.022), and C-reactive protein (OR 1.383~18.793, P = 0.014) were the independent risk factors for PAD. Conclusions MHD patients of older age, longer dialysis age, diabetes, lower Kt/v, abdominal obesity, lower albumin level, higher alkaline phosphatase, increased C-reactive protein, hypertriglyceridemia, and cerebral vascular disease history had a relatively higher risk of PAD.
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