血清胱抑素C、肌酐和脑钠钛预测慢性肾脏病维持性血液透析心血管事件的价值

doi:10.3969/j.issn.1671-7171.2019.07.009

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摘要 【目的】探讨血清胱抑素C(Cys-C)、肌酐(SCr)和脑钠钛(BNP)预测慢性肾脏病(CDK)维持性血液透析(MHD)患者心血管事件的价值。【方法】本院行MHD治疗的CDK患者153例,随访24个月,根据末次随访时有无心血管事件发生分为心血管事件组(A组,n=51)和无心血管事件组(B组,n=102)。收集患者基本情况及血尿素氮(BUN)、血全段甲状旁腺激素(iPTH)、Cys-C、SCr、BNP等资料。采用回归分析发生心血管事件的独立危险因素。以受试者工作曲线(ROC)分析Cys-C、SCr、BNP预测心血管事件的价值。【结果】A组患者的年龄、透析龄、血钙、血iPTH、血尿酸、血BUN、Cys-C、SCr、BNP均明显高于B组(P＜0.05)。Cys-C、SCr和BNP与透析龄、血钙、血iPTH、血尿酸、血BUN均呈正相关(P＜0.05)。Logistic逐步回归分析显示:血iPTH、血尿酸、Cys-C、SCr、BNP是MHD患者发生心血管事件的独立危险因素(P＜0.05)。Cys-C、SCr和BNP预测心血管事件发生的曲线下面积分别为0.705、0.614和0.739;灵敏度分别为79.2%、71.4%和84.3%;特异度分别为73.5%、67.3%和86.5%。【结论】Cys-C、SCr和BNP是MHD 患者发生心血管事件的独立危险因素,能够有效预测心血管事件的发生。

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	张宏
	李小伟
	孙国明

关键词 ：肾疾病/血液, 抑素类, 利钠肽, 脑

Abstract：【Objective】To investigate the value of serum cystatin C (Cys-C), serum creatinine (Scr) and brain natriuretic peptide (BNP) in predicting cardiovascular events in chronic kidney disease (CDK) patients treated with maintenance hemodialysis (MHD).【Methods】A total of 153 CDK patients who were treated with MHD in our hospital were followed up for 24 months. According to the cardiovascular events at the last follow-up, patients were divided into the cardiovascular event group (group A,n=51) and the non-cardiovascular event group (group B,n=102). Patients' clinical data, blood urea nitrogen (BUN), parathyroid hormone (iPTH), serum Cys-C, Scr and BNP were collected. Regression analysis was performed to identify independent risk factors for cardiovascular events. Receiver operating curve (ROC) was used to analyze the value of Cys-C, Scr and BNP in predicting cardiovascular events.【Results】Patients' age, dialysis time period, serum calcium (Ca), iPTH, uric acid, BUN, Cys-C, Scr and BNP in group A were significantly higher than those in group B (P<0.05). Cys-C, Scr and BNP were positively correlated with dialysis time period, serum Ca, iPTH, uric acid and BUN (P<0.05). Multivariate logistic stepwise regression analysis showed that iPTH, uric acid, Cys-C, Scr and BNP were independent risk factors for cardiovascular events in MHD patients (P<0.05). The areas under ROC curve of Cys-C, Scr and BNP in predicting cardiovascular events were 0.705, 0.614 and 0.739, respectively. The sensitivity was 79.2% for Cyc-C, 71.4% for Scr and 84.3% for BNP;And the specificity was 73.5%,67.3% and 86.5%, respectively.【Conclusion】Cys-C, Scr and BNP are independent risk factors for cardiovascular events in CDK patients with MHD and can predict the occurrence of cardiovascular events.

Key words： Kidney Diseases/BL Chalones Natriuretic Peptide, Brain

收稿日期: 2018-09-29

PACS:

R692

通讯作者: E-mail:2804783371@qq.com

引用本文:

张宏, 李小伟, 孙国明. 血清胱抑素C、肌酐和脑钠钛预测慢性肾脏病维持性血液透析心血管事件的价值[J]. 医学临床研究, 2019, 36(7): 1273-1275.
ZHANG Hong, LI Xiao-wei, SUN Guo-ming. Value of Serum Cys-C , Scr and BNP in Predicting Cardiovascular Events in Chronic Kidney Disease Patients Treated with Maintenance Hemodialysis. JOURNAL OF CLINICAL RESEARCH, 2019, 36(7): 1273-1275.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.07.009 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I7/1273