本文選題：腹膜透析　切入點(diǎn)：心血管鈣化　出處：《南京大學(xué)》2017年碩士論文

【摘要】：目的:動態(tài)觀察腹膜透析(PD)患者心血管鈣化的患病率和演變情況,分析影響鈣化的因素及其臨床意義。方法:前瞻性觀察150名PD患者,評估患者基線臨床特征及心血管鈣化的患病率,所有患者隨訪30個(gè)月,分別于第0,12和24個(gè)月進(jìn)行1次心血管鈣化的影像學(xué)評估。利用Logistic回歸分析影響心血管鈣化及進(jìn)展的相關(guān)因素;利用Kaplan-Meier法計(jì)算患者的全因或心血管疾病(CVD)死亡率以及非致死性心血管事件(CVE)的發(fā)生率;采用COX回歸分析相關(guān)危險(xiǎn)因素。結(jié)果:基線時(shí)57.3%的患者存在有鈣化,至隨訪結(jié)束,心血管鈣化率升至63.2%,在53.5%的患者中觀察到鈣化進(jìn)展。隨訪中5.3%的患者死亡,最常見的死因是CVD(75%),CVE的發(fā)生率為19.3%。有臨床意義鈣化的患者的全因死亡(p=0.004)和CVD死亡(p=0.002)顯著高于其他患者。低蛋白血癥及二尖瓣鈣化是全因死亡和CVD死亡的獨(dú)立危險(xiǎn)因素;年齡46歲、高密度脂蛋白-膽固醇及冠狀動脈鈣化和心臟瓣膜鈣化的合并存在是發(fā)生CVE的獨(dú)立危險(xiǎn)因素。結(jié)論:PD患者合并心血管鈣化的患病率較高,病變進(jìn)展較快,與CVD的發(fā)生有著密切的聯(lián)系,心血管鈣化對整體預(yù)后產(chǎn)生不良影響。
[Abstract]:Objective: To observe the peritoneal dialysis (PD) patients with cardiovascular calcification prevalence and evolution, analysis of factors affecting calcification and its clinical significance. Methods: a prospective study of 150 patients with PD, the prevalence rate of assessment of patients with baseline clinical characteristics and cardiovascular calcification, all patients were followed up for 30 months, respectively, 1 times of cardiovascular calcification imaging evaluation on 0,12 and 24 months. Regression analysis of factors related to cardiovascular calcification and progress by Logistic; calculation of patients with all-cause or cardiovascular disease by the method of Kaplan-Meier (CVD) mortality and nonfatal cardiovascular events (CVE) occurrence rate; COX regression was used to analyze the related risk factors. Results: at baseline there were 57.3% patients with calcification, to the end of follow-up, cardiovascular calcification rate rose to 63.2%, was observed in 53.5% of the patients died during the follow-up to the progress of calcification. 5.3% of the patients, the most common cause of death is CV D (75%), the incidence of CVE was 19.3%. with clinical significance of calcification in patients with all-cause death (p=0.004) and CVD (p=0.002) was significantly higher than other patients. Hypoproteinemia and mitral valve calcification was all-cause death and CVD independent risk factors of death; 46 years of age, with high density lipoprotein cholesterol and coronary artery calcification and cardiac valve calcification is an independent risk factor of CVE. Conclusion: PD patients with a high prevalence of cardiovascular calcification lesions, rapid progress, has close relationship with the occurrence of CVD, cardiovascular calcification have adverse effects on the overall prognosis.

【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5
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本文編號：1689279