本文關(guān)鍵詞： 超敏肌鈣蛋白 維持性血液透析 危險分級 預(yù)后評估　出處：《復(fù)旦學(xué)報(醫(yī)學(xué)版)》2017年04期 　論文類型：期刊論文

【摘要】：目的探討超敏肌鈣蛋白(high-sensitivity cardiac troponin T,hs-cTnT)對維持性血液透析(maintainance hemodialysis,MHD)患者的短期預(yù)后作用。方法入組296例MHD患者,回顧性分析其臨床資料,患者血液透析前采集血清檢測hs-cTnT和相關(guān)心血管風(fēng)險標志物。隨訪時間總長為13個月,記錄主要終點事件(全因死亡)及發(fā)生時間;用t檢驗、Mann-Whitney U檢驗和χ2檢驗分析比較全因死亡與生存組風(fēng)險標志物之間的差異,使用X-tile計算出hs-cTnT的最佳二分位切點,繪制Kaplan-Meier生存曲線,用Logistic回歸分析高危及非高危hs-cTnT之間的死亡風(fēng)險比。根據(jù)hs-cTnT健康人群第99百分位點將非高危組細分為中危組和低危組來進一步評估其對MHD患者短期預(yù)后的影響。結(jié)果 MHD患者生存與全因死亡組的血清hs-cTnT水平分別為0.05(0.03~0.07)ng/mL和0.07(0.04~0.14)ng/mL(P=0.027);hs-cTnT的最佳二分位切點為0.1 ng/mL;高危組(hs-cTnT0.1 ng/mL)患者生存率(76.67%)顯著低于非高危組(hs-cTnT≤0.1 ng/mL)患者生存率(96.62%)(P0.05);高危組患者死亡風(fēng)險較非高危組患者高7.288倍(P0.001);在非高危人群組中,中危組(hs-cTnT0.014 ng/mL)患者生存率低于低危組(hs-cTnT≤0.014 ng/mL)患者生存率,低危組在隨訪期間無死亡事件發(fā)生。結(jié)論 hs-cTnT是MHD患者死亡的獨立危險因素,并可作為MHD患者短期的死亡風(fēng)險分級和預(yù)后評估的有力指標。
[Abstract]:Objective to investigate the short-term prognostic effect of high-sensitivity cardiac troponin TnT on maintainance hemodialysis (MHD) patients. Methods 296 patients with MHD were enrolled and their clinical data were analyzed retrospectively. Serum samples were collected before hemodialysis to detect hs-cTnT and related cardiovascular risk markers. The total follow-up time was 13 months. The main end point events (all causes of death) and the time of occurrence were recorded. T test Mann-Whitney U test and 蠂 2 test were used to compare the difference between the risk markers of all-cause death and survival group. X-tile was used to calculate the best binary tangent point of hs-cTnT and draw the survival curve of Kaplan-Meier. The mortality risk ratio between high and non-high risk hs-cTnT was analyzed by Logistic regression analysis. According to the 99th percentile of hs-cTnT healthy population, the non high risk group was subdivided into middle risk group and low risk group to further evaluate its impact on the short-term prognosis of MHD patients. The serum hs-cTnT levels of patients with MHD were 0.05ng / mL and 0.07ng / mL, respectively, and 0.07ng / mL and 0.07ng / g / mL of 0.07ng / mL and 0.07ng / 0.04 / 0.14ng / ml respectively. The optimal binary-point of 0.027ng- cTnT was 0.1 ng / mL; the survival rate of patients with high risk group was 76.67); the survival rate of patients with Hs-cTnTnT 鈮，

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