Analysis of risk factors associated with coronary artery calcium in maintenance hemodialysis patients
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摘要: 目的:了解维持性血液透析(MHD)患者冠状动脉(冠脉)钙化情况,分析其危险因素。方法:纳入2019年1月—2020年10月成都医学院第一附属医院肾病科MHD患者154例,多层螺旋CT计算冠脉钙化积分;根据冠脉钙化积分结果将入选患者分为重度钙化组(冠脉钙化积分>400,45例)和非重度钙化组(冠脉钙化积分<400,109例),并收集患者的一般情况、临床资料和血生化指标。结果:重度钙化组的年龄、透析龄、冠心病史、碱性磷酸酶、血镁水平与非重度钙化组差异有统计学意义(P<0.05)。二元logistic回归分析发现年龄、透析龄、碱性磷酸酶是冠脉钙化的独立危险因素(P<0.05)。高血镁水平是冠脉钙化的保护因素(P<0.05),ROC曲线判断血镁对MHD患者重度冠脉钙化的预测价值,其中血清镁最佳截断值为0.925 mmol/L,敏感性为76.1%,特异性为71.1%,曲线下面积为0.822(P<0.001)。结论:MHD患者普遍存在冠脉钙化,年龄、透析龄、碱性磷酸酶是冠脉钙化独立危险因素,高血镁水平是冠脉钙化的保护因素,血清镁对MHD患者重度冠脉钙化有着良好的预测价值。Abstract: Objective: To investigate the risk factors of coronary artery calcification in maintenance hemodialysis(MHD) patients.Methods: A total of 154 patients with MHD was enrolled in the Department of Nephrology, First Affiliated Hospital of Chengdu Medical College from January 2019 to October 2020. The coronary artery calcification score was calculated by multi-slice spiral CT; According to the coronary artery calcium score, the selected patients were divided into severe calcification group(coronary artery calcification score>400, n=45) and non-severe calcification group(coronary artery calcification score<400, n=109).Results: There were significant differences in age, dialysis age, history of coronary heart disease, alkaline phosphatase and serum magnesium level between severe calcification group and non severe calcification group(P<0.05). Binary logistic regression analysis found that advanced age, dialysis age, alkaline phosphatase was independent risk factors for coronary artery calcification(P<0.05), and hypermagnesium was a protective factor for coronary artery calcification(P<0.05). ROC curve judged the predictive value of serum magnesium to severe coronary calcification in patients with MHD. The best cut-off value of serum magnesium was 0.925 mmol/L, sensitivity was 76.1%, specificity was 71.1%, and area under the curve was 0.822(P<0.001).Conclusion: Coronary artery calcification is common in MHD patients. Age, dialysis age, and alkaline phosphatase are independent risk factors for coronary artery calcification, and hypermagnesium is a protective factor for coronary artery calcification. Serum magnesium has a good predictive value for severe coronary calcification in MHD patients.
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Key words:
- maintenance hemodialysis /
- coronary artery calcification /
- risk factors /
- serum magnesium
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