单核细胞/高密度脂蛋白比值对老年维持性血液透析病人主动脉弓钙化的预测价值

doi:10.3969/j.issn.1003-9198.2022.04.007

摘要/Abstract

摘要： 目的探索单核细胞/高密度脂蛋白比值(monocyte-to-HDL-cholesterol ratio,MHR)对老年维持性血液透析(MHD)病人主动脉弓钙化的预测价值。方法选取符合纳入标准的老年MHD病人61例,收集病人临床资料,计算MHR,根据胸部X线钙化评级设定的主动脉弓钙化程度分为轻度钙化组、中度钙化组和重度钙化组。动脉弓钙化与各指标之间的相关性采用Spearman相关分析;应用多元Logistic回归分析主动脉弓钙化的影响因素。结果与轻度钙化组比较,中度钙化组和重度钙化组MHR、血小板/淋巴细胞计数(PLR)、碱性磷酸酶(ALP)、校正钙水平明显增高,白蛋白水平降低,差异具有统计学意义(P<0.05)。相关性分析显示,主动脉弓钙化程度与MHR、中性粒细胞计数/淋巴细胞计数(NLR)、PLR、矫正钙、ALP水平呈正相关(r分别为0.611、0.376、0.339、0.322、0.519,均P<0.05),与白蛋白水平呈负相关(r=-0.309,P<0.05)。多因素回归分析提示,MHR(OR=6.612,95%CI: 2.697~10.528,P=0.001)是老年MHD病人主动脉弓钙化发生的独立危险因素。ROC曲线提示,MHR对主动脉弓中重度钙化具有预测价值,其灵敏度为87%,最佳截断值为0.407。结论 MHR对老年MHD病人主动脉弓钙化及其程度具有临床预测价值。

关键词: 老年人, 维持性血液透析, 主动脉弓钙化, 单核细胞/高密度脂蛋白

Abstract: Objective To explore the relationship between monocyte to high density lipoprotein-cholesterol ratio (MHR) and aortic arch calcification in the elderly patients undergoing maintenance hemodialysis(MHD). Methods A total of sixty-one elderly MHD patients who met the inclusion criteria were selected, and the clinical data of the patients were collected. According to the chest X-ray calcification rating of aortic arch calcification degree, the patients were divided into mild calcification group, moderate calcification group and severe calcification group. Spearman correlation analysis was used to analyze the relationship between the aortic arch calcification and the related indexes. Multiple Logistic regression analysis was used to analyze the risk factors of the aortic arch calcification. Results Compared with mild calcification group, the levels of MHR, neutrophil count / lymphocyte count (NLR), platelet to lymphocyte ratio (PLR),alkaline phosphatase (ALP) and corrective calcium were significantly increased, while the level of albumin was significantly decreased in moderate and severe calcification groups(P<0.05). Aortic arch calcification was positively correlated with MHR, NLR, PLR,corrected calcium and ALP(r=0.611,0.376,0.339,0.322,0.519, respectively, all P<0.05), and negatively correlated with albumin(r=-0.309,P<0.05). Multivariate regression analysis showed that MHR(OR=6.612,95%CI: 2.697-10.528,P=0.001)was an independent risk factor for aortic arch calcification in the elderly MHD patients. ROC curve showed that MHR had value in predicting moderate and severe aortic arch calcification, with a sensitivity of 87% and the optimal cut-off value of 0.407. Conclusions MHR has clinical predictive value for aortic arch calcification in the elderly MHD patients.

Key words: aged, maintenance hemodialysis, aortic arch calcification, monocyte to high density lipoprotein-cholesterol ratio

中图分类号:

R 459.5

邹春波, 于平, 刘海飞, 苏婷婷, 陈小芹. 单核细胞/高密度脂蛋白比值对老年维持性血液透析病人主动脉弓钙化的预测价值[J]. 实用老年医学, 2022, 36(4): 350-353.

ZOU Chun-bo, YU Ping, LIU Hai-fei, SU Ting-ting, CHEN Xiao-qin. Correlation between monocyte-to-HDL-cholesterol ratio and aortic arch calcification in elderly hemodialysis patients[J]. Practical Geriatrics, 2022, 36(4): 350-353.

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