老年糖尿病肾病患者行维持性血液透析发生血管钙化及其影响因素分析

Analysis of vascular calcification and its influencing factors in elderly patients with diabetes nephropathy undergoing mainte-nance hemodialysis

中文关键词: 老年  糖尿病肾病  维持性血液透析  血管钙化  影响因素

英文关键词: elderly  diabetic nephropathy  maintenance hemodialysis  vascular calcification  influencing factor

中文摘要:

      目的 分析进行维持性血液透析的老年糖尿病肾病患者发生血管钙化情况及其影响因素,为其防治提供依据.方法 回顾性分析2020 年2 月—2022 年2 月于青岛市胶州中心医院进行维持性血液透析治疗的138 例老年糖尿病肾病患者一般资料、影像学资料及实验室指标.根据患者的影像学诊断结果,分析老年糖尿病肾病维持性血液透析患者血管钙化发生率.依据患者是否发生血管钙化分为钙化组和未钙化组.采用单因素分析及多因素Logistic回归分析血管钙化的影响因素.结果 138 例老年糖尿病肾病维持性血液透析患者中,发生血管钙化93 例(67.39%)(设为钙化组),45 例(32.61%)患者未发生血管钙化(设为未钙化组).2 组性别、身体质量指数(BMI)、腹围、冠心病、平均动脉压、三酰甘油、血清白蛋白、25 羟维生素D评估值差异均无统计学意义(P＞0.05),而年龄、透析时间、血磷、血钙、超敏C反应蛋白评估值差异均有统计学意义(P＜0.05).多因素Logistic回归分析显示,年龄增加、透析时间延长、血钙水平升高、超敏C反应蛋白水平升高为老年糖尿病肾病维持性血液透析患者血管钙化的影响因素(P＜0.05).结论 维持性血液透析的老年糖尿病肾病患者的血管钙化发生率较高,其影响因素可能有患者年龄增加、透析时间延长、血钙水平升高、超敏C反应蛋白水平升高,临床应当加以重视,并采取早期防治措施.

英文摘要:

      Objective To analyze the incidence of vascular calcification and its influencing factors in elderly patients with diabetic nephropathy undergoing maintenance hemodialysis,and provide evidence for its prevention and treatment.Methods The general data,imaging data and laboratory indicators of 138 elderly patients with diabetic nephropathy who un-derwent maintenance hemodialysis in Jiaozhou Central Hospital of Qingdao City from February 2020 to February 2022 were ana-lyzed retrospectively.The incidence of vascular calcification in these patients was analyzed according to their imaging diagnosis results.According to whether the patients had vascular calcification or not,they were divided into calcification group and non-calcification group.The influencing factors of vascular calcification were analyzed by univariate analysis and multiple logistic regression analysis.Results Among 138 elderly patients with diabetic nephropathy undergoing maintenance hemodialysis,93 ones(67.39%)had vascular calcification(calcification group)and 45 ones(32.61%)had no vascular calcification(non-calcification group).There was no statistically significant difference in gender,body mass index(BMI),abdominal circum-ference,coronary heart disease,mean arterial pressure,triglyceride,serum albumin and 25-hydroxyvitamin D between the two groups(P＞0.05),while there were statistically significant differences in age,dialysis time,blood phosphorus,blood calcium and high-sensitivity C-reactive protein between the two groups(P＜0.05).Multivariate logistic regression analysis showed that increasing age,prolonged dialysis time,elevated blood calcium level and elevated hypersensitive C-reactive protein level were the influential factors for vascular calcification in elderly patients with diabetic nephropathy undergoing maintenance hemodialy-sis(P＜0.05).Conclusion The incidence of vascular calcification is higher in elderly patients with diabetic nephropathy un-dergoing maintenance hemodialysis.Its influencing factors may include increasing age,prolonged dialysis time,elevated blood calcium level and elevated hypersensitive C-reactive protein level.Therefore,clinical attention should be paid to these influen-cing factors and early prevention and treatment measures should be taken.