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目的:探讨维持性血液透析患者冠状动脉钙化发生及进展的危险因素。方法:选择在广东省人民医院血液净化中心维持性血液透析≥6月的患者62例,完善相关实验室检查,螺旋CT检测冠状动脉钙化评分,入组后每6个月检测血钙、磷、全段甲状旁腺激素(i PTH),并在随访2年后再次复查冠状动脉钙化评分。结果:本组患者冠状动脉钙化的总发生率为70.97%,其中冠状动脉钙化积分>100的患者占68.18%。有、无冠状动脉钙化两组患者在年龄、总胆固醇水平、合并腹主动脉钙化、左房直径、右房直径有显著差异。多因素分析发现,总胆固醇水平是发生冠状动脉钙化的独立危险因素。共有47例患者完成了2年后的冠状动脉CT复查,其中61.70%的患者钙化积分进展。平均血钙水平较高是钙化进展的独立危险因素。结论:维持性血液透析患者冠状动脉钙化发生率高,血胆固醇升高是冠状动脉钙化发生的危险因素;血钙水平较高与冠状动脉钙化进展有关。
Objective: To explore the risk factors of coronary artery calcification in maintenance hemodialysis patients. Methods: Sixty-two patients with maintenance hemodialysis ≥ 6 months were enrolled in the Guangdong Provincial People’s Hospital Blood Purification Center. The related laboratory tests were completed and the coronary calcium score was detected by spiral CT. Blood calcium, phosphorus, Full parathyroid hormone (i PTH) was administered and coronary artery calcification scores were reviewed again 2 years after follow-up. Results: The total incidence of coronary artery calcification in this group was 70.97%, 68.18% of whom had coronary artery calcification score> 100. Yes, no coronary artery calcification in two groups of patients age, total cholesterol, with abdominal aortic calcification, left atrial diameter, right atrial diameter were significantly different. Multivariate analysis found that total cholesterol was an independent risk factor for coronary artery calcification. A total of 47 patients completed a coronary CT review two years later, with 61.70% of patients progressing with calcification. The higher average blood calcium level is an independent risk factor for the progression of calcification. Conclusions: The incidence of coronary artery calcification in patients with maintenance hemodialysis is high, and hypercholesterolemia is the risk factor of coronary artery calcification. The higher level of serum calcium correlates with the progression of coronary artery calcification.