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临床研究

维持性血液透析患者并发腹主动脉钙化危险因素的Meta分析

  • 黄欣萍
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  • 543000 梧州,1梧州市工人医院肾内科

收稿日期: 2024-01-25

  修回日期: 2024-04-28

  网络出版日期: 2024-07-12

基金资助

梧州市科学研究与技术开发计划项目(201702036)

The risk factors for abdominal aortic calcification in maintenance hemodialysis patients: a Meta-analysis

  • HUANG Xin-Ping
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  • Department of Nephrology, Wuzhou Workers' Hospital, Wuzhou 543000, China

Received date: 2024-01-25

  Revised date: 2024-04-28

  Online published: 2024-07-12

摘要

目的  系统性分析我国维持性血液透析(maintenance hemodialysis,MHD)患者并发腹主动脉钙化(abdominal aorta calcification,AAC)的危险因素。 方法 通过计算机对PubMed、Embase、Web of Science、中国知网、中国生物医学文献数据库CBM、万方等数据库检索关于中国MHD患者并发AAC危险因素的文献(时限为建库至2023年5月),采用纽卡斯尔-渥太华量表(Newcastle-Ottawa scale,NOS)、美国卫生保健质量和研究机构评价标准(agency for healthcare research and quality,AHRQ)进行方法学文献质量评价。采用RevMan 5.3软件进行Meta分析。 结果 共纳入15篇文献,其中10篇中文文献,5篇英文文献,包含2848例研究对象。Meta分析结果显示高龄(OR=1.080,95% CI:1.050~1.110,P<0.001)、长透析龄(OR=1.020,95% CI:1.010~1.040,P=0.008)、吸烟(OR=1.900,95% CI:1.440~2.500,P<0.001)、高体质量指数(body mass index,BMI)(OR=1.200,95% CI:1.050~1.110,P=0.001)、血钙升高(OR=14.140,95% CI:7.340~27.260,P<0.001)、血磷升高(OR=6.010,95% CI:2.040~17.750,P=0.001)、甲状旁腺激素升高(OR=1.310,95% CI:1.010~1.700,P=0.040)以及血镁(OR=0.490,95% CI:0.400~0.590,P<0.001)、25羟基维生素D3降低(OR=0.760,95% CI:0.610~0.950,P=0.020)为MHD患者并发AAC的危险因素。 结论  维持性血液透析患者并发腹主动脉钙化的影响因素较多,应重点关注高危人群,进行针对性、个性化干预,延缓MHD患者腹主动脉钙化的进展。

本文引用格式

黄欣萍 . 维持性血液透析患者并发腹主动脉钙化危险因素的Meta分析[J]. 中国血液净化, 2024 , 23(07) : 524 -528 . DOI: 10.3969/j.issn.1671-4091.2024.07.008

Abstract

Objective  To systematically analyze the risk factors for abdominal aortic calcification (AAC) in Chinese maintenance hemodialysis (MHD) patients.   Methods  PubMed, EMBASE, Web of Science, CNKI, CBM, Wanfang and other databases were searched from establishment of the database to May 2023 by computer to retrieve the literature relating to the risk factors for AAC in Chinese MHD patients. The Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) were used to evaluate the methodological quality of the literature. Meta-analysis was performed using RevMan5.3 software.  Results  A total of 15 articles were obtained, including 10 Chinese articles and 5 English articles and encompassing 2,848 subjects. The results of Meta-analysis showed that older age (OR=1.080, 95% CI: 1.050~1.110, P<0.001), longer dialysis age (OR=1.020, 95% CI: 1.010~1.040, P=0.008), smoking (OR=1.900, 95% CI: 1.440~2.500, P<0.001), higher body mass index (BMI) (OR=1.200, 95% CI: 1.050~1.110, P=0.001), increased blood calcium (OR=14.140, 95% CI: 7.340~27.260, P<0.001), elevated blood phosphorus (OR=6.010, 95% CI: 2.040~17.750, P=0.001), elevated parathyroid hormone (OR=1.310,95% CI:1.010~1.700,P=0.040), elevated blood magnesium(OR=0.490, 95% CI:0.400~0.590, P<0.001) and decreased 25-hydroxyvitamin D3 (OR=0.760, 95% CI: 0.610~0.950, P=0.020) were the risk factors for AAC in MHD patients.  Conclusion  There are many influencing factors for AAC in MHD patients. We should focus on the high-risk groups and carry out targeted and personalized interventions to delay the progress of AAC in MHD patients.

参考文献

[1] Zhu X, Cai H, Zhu M, et al. Association of abdominal aortic calcification estimated by plain radiography with outcomes in haemodialysis patients: A 6-year follow-up study[J]. Nephrology (Carlton), 2020,;25(7):559-565.
[2] Jean G, Mayor B, Deleaval P, et al. Vascular Calcification Progression Is an Independent Predictor of Mortality in Patients on Haemodialysis[J]. Nephron, 2015,130(3):169-74.
[3] Yan J, Li L, Zhang M, et al. Circulating bone-specific alkaline phosphatase and abdominal aortic calcification in maintenance hemodialysis patients[J]. Biomark Med, 2018, 12(11):1231-1239.
[4] 杨洁,陈天怡,王玲. 维持性血液透析患者腹主动脉钙化的危险因素[J]. 中国老年学杂志,2021,41(16):3467-3471.
[5] 符业,李灿,胡波. 维持性血液透析患者腹主动脉钙化危险因素的相关性分析[J]. 川北医学院学报,2019,34(2):235-237.
[6] 李佳,王玉,刘怡彤,等. 老年营养风险指数联合血清补体C3水平在维持性血液透析患者腹主动脉钙化评估中的价值[J]. 山东医药,2022,62(10):30-34.
[7] Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010,25(9):603-5.
[8] 曾宪涛,刘慧,陈曦,等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志,2012,4(4):297-299.
[9] Cai H, Lu R, Zhang M, et al. Serum Soluble Klotho Level Is Associated with Abdominal Aortic Calcification in Patients on Maintenance Hemodialysis[J]. Blood Purif, 2015,40(2):120-6.
[10] 马潭涌,郝丽荣. 维持性血液透析患者腹主动脉钙化的相关因素分析[J]. 肾脏病与透析肾移植杂志,2017,26(5):414-419.
[11] Zhang H, Li G, Yu X, et al. Progression of Vascular Calcification and Clinical Outcomes in Patients Receiving Maintenance Dialysis[J]. JAMA Netw Open, 2023,6(5):e2310909.
[12] 丁新国,叶美玲,梁李娜,等. 血清apelin、骨硬化蛋白与维持性血液透析患者腹主动脉钙化的相关性分析[J]. 临床合理用药杂志,2021,14(9):27-30.
[13] 宋玉环,郎佳慧,李苹苹,等. 维持性血液透析患者腹主动脉钙化特点及影响因素分析[J]. 临床肾脏病杂志,2020,20(12):951-954.
[14] 马涛,李秀勇. CKD3~5期维持性血液透析患者腹主动脉钙化的发生及其进展相关因素[J]. 临床与病理杂志,2021,41(4):770-776.
[15] 郑佩兰,林曰勇,庄永泽,等. 维持性血液透析患者腹主动脉钙化进展的危险因素分析[J]. 中国中西医结合肾病杂志,2022,23(11):968-971.
[16] 李新玉,王雪荣,袁亮,等. 三酰甘油葡萄糖乘积指数对维持性血液透析患者腹主动脉钙化的评估价值[J]. 中国血液净化,2023,22(1):17-21.
[17] 王小华,陈建平,陈蓉,等. 单核细胞/高密度脂蛋白比值及钙/镁比值与维持性血液透析患者血管钙化的相关性分析[J]. 临床合理用药杂志,2021,14(36):28-31.
[18] 王雪梅,祝再然,李志萍,等. 血清Irisin及BMP-7对维持性血液透析患者并发腹主动脉钙化的诊断价值[J]. 山东医药,2020,60(16):30-33.
[19] 祝旭颖,蔡宏,张伟明,等. 维持性血液透析患者血清成纤维细胞生长因子23与腹主动脉钙化及预后的关系[J]. 中华肾脏病杂志,2017,33(9):678-685.
[20] 胡海英,黄静,刘春. 维持性血液透析患者血清骨硬化蛋白与腹主动脉钙化的关系及影响因素Logistics回归分析[J]. 吉林医学,2021,42(2):372-375.
[21] Bartstra JW, Mali WPTM, Spiering W, et al. Abdominal aortic calcification: from ancient friend to modern foe[J]. Eur J Prev Cardiol, 2021,28(12):1386-1391.
[22] Choi SR, Lee YK, Cho AJ, et al. Malnutrition, inflammation, progression of vascular calcification and survival: Inter-relationships in hemodialysis patients[J]. PLoS One, 2019, 14(5):e0216415.
[23] Kondo T, Nakano Y, Adachi S, et al. Effects of Tobacco Smoking on Cardiovascular Disease[J]. Circ J, 2019,83(10):1980-1985.
[24] Reynolds LM, Zamora C, Lee UJ, et al. Tobacco Use Prevalence and Transitions From 2013 to 2018 Among Adults With a History of Cardiovascular Disease[J]. J Am Heart Assoc, 2021, 10(12):e021118.
[25] Lumlertgul D, Kantachuvesiri S, Apichaiyingyurd S, et al. Prevalence of and Predictive Factor for Abdominal Aortic Calcification in Thai Chronic Kidney Disease Patients[J]. Ther Apher Dial, 2017,21(6):611-619.
[26] 郑梅咏. 慢性肾脏病患者心血管系统钙化的影响因素研究[J]. 心血管病防治知识,2023,13(3):23-25.
[27] Durham AL, Speer MY, Scatena M, et al. Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness[J]. Cardiovasc Res, 2018,114(4):590-600.
[28] Rodríguez-Ortiz ME, Rodríguez M. Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease[J]. F1000Res, 2020,9:F1000 Faculty Rev-1077.
[29] Chen W, Fitzpatrick J, Monroy-Trujillo JM, et al. Diabetes Mellitus Modifies the Associations of Serum Magnesium Concentration With Arterial Calcification and Stiffness in Incident Hemodialysis Patients[J]. Kidney Int Rep, 2019,4(6):806-813.
[30] 周自英,张颖,冯锦红,等. 维持性血液透析患者血清镁与腹主动脉钙化及矿物质代谢的关系[J]. 国际泌尿系统杂志,2020,40(5):860-863.
[31] Cardoso MP, Pereira LAL. Native vitamin D in pre-dialysis chronic kidney disease[J]. Nefrologia (Engl Ed), 2019,39(1):18-28.
[32] Wang F, Wu S, Ruan Y, et al. Correlation of serum 25-hydroxyvitamin D level with vascular calcification in hemodialysis patients[J]. Int J Clin Exp Med, 2015,8(9):15745-51.
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