摘要
目的探讨维持性血液透析(MHD)患者的血镁特点及其对血管钙化的预测价值。方法选取成都医学院第一附属医院2019年1月至2021年3月行MHD治疗的患者175例作为研究对象,按血镁水平分为低镁组(镁<0.88 mmol/L,n=46)、中镁组(0.88 mmol/L≤镁≤1.1 mmol/L,n=84)和高镁组(镁>1.1 mmol/L,n=45)。比较各组临床资料的差异。结果 3组年龄、白蛋白、前白蛋白、磷水平比较,差异均有统计学意义(P<0.05),其中高镁组和中镁组白蛋白、前白蛋白高于低镁组,年龄低于低镁组,高镁组血磷高于低镁组和中镁组,差异均有统计学意义(P<0.05)。多元线性回归分析显示,MHD患者血镁水平与白蛋白、磷水平呈正相关,与年龄呈负相关(P<0.05)。3组冠脉钙化积分组间两两比较,差异有统计学意义(P<0.05),且血镁水平越低冠脉钙化积分越高。3组患者心脏瓣膜钙化率、胸主动脉钙化积分差异有统计学意义(P<0.05),其中低镁组胸主动脉钙化积分高于中镁组和高镁组,瓣膜钙化率高于高镁组。ROC曲线分析显示,重度冠脉钙化、重度胸主动脉钙化、心脏瓣膜钙化的镁离子最佳截点值分别为0.875、0.855、1.105 mmol/L;灵敏度分别为86.3%、91.5%、31.4%;特异性分别为56.9%、34.4%、86.0%;曲线下面积分别为0.791(95%CI 0.718~0.865),0.657(95%CI 0.577~0.737),0.623(95%CI 0.535~0.710),差异有统计学意义(P<0.05)。结论血镁对重度冠脉钙化、重度胸主动脉钙化和心脏瓣膜钙化均有一定预测价值,但对重度冠脉钙化的预测价值更优。
Objective To explore the characteristics of serum magnesium(Mg) level and its predictive value for vascular calcification in patients undergoing maintenance hemodialysis(MHD) therapy. Methods A total of 175 patients underwent MHD therapy from January 2019 to March 2021 in the First Affiliated Hospital of Chengdu Medical College were included and divided into 3 groups according to serum Mg level: low Mg group(Mg<0.88 mmol/L, n=46), medium Mg group(0.88 mmol/L≤Mg≤1.1 mmol/L, n=84) and high Mg group(Mg>1.1 mmol/L, n=45). Clinical data of each group were analyzed and compared. Results The differences in age, albumin, pre-albumin and phosphorus levels among the three groups were statistically significant(P<0.05). And the high Mg group and the medium Mg group had higher albumin and pre-albumin levels but lower age compared with the low Mg group, the high Mg group had higher phosphorus levels compared with the the low Mg group and the medium Mg group, and the differences were statistically significant(P<0.05). Multiple linear regression analysis showed that serum Mg level of MHD patients was positively correlated with serum albumin and phosphorus levels, and negatively correlated with age(P<0.05). Pairwise comparison of coronary artery calcification scores among 3 groups showed statistically significant difference(P<0.05), and the lower the serum Mg level, the higher the coronary artery calcification score. There were statistically significant differences in cardiac valve calcification rate and thoracic aortic calcification score among the three groups(P<0.05), and the low Mg group had higher thoracic aortic calcification score compared with the the medium Mg group and the high Mg group, and had higher cardiac valve calcification rate compared with the high Mg group. ROC curve analysis showed that the optimal cut-off points of Mg ions for severe coronary artery calcification, severe thoracic aortic calcification and cardiac valve calcification were 0.875, 0.855 and 1.105 mmol/L respectively;the sensitivity were 86.3%, 91.5% and 31.4% respectively;the specificity were 56.9%, 34.4% and 86.0%, respectively;the areas under the curve were 0.791(95%CI 0.718-0.865), 0.657(95%CI 0.577-0.737) and 0.623(95%CI 0.535-0.710), respectively(P<0.05). Conclusion Serum Mg level has a better predictive value for severe coronary artery calcification than for severe thoracic aortic calcification and cardiac valve calcification in MHD patients, even though it has certain predictive value for all of them.
作者
赖玮婧
王少清
江玉波
毛楠
Lai Weijing;Wang Shaoqing;Jiang Yubo;Mao Nan(Department of Nephrology,Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Collaborative Innovation Center of Sichuan for Elderly Care and Health,Chengdu Medical College,Chengdu 610500,China;The Second Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital,Chengdu 610057,China)
出处
《成都医学院学报》
CAS
2021年第6期738-742,746,共6页
Journal of Chengdu Medical College
基金
成都市卫生健康委员会医学科研课题(No:2019075)
成都医学院四川养老与老年健康协同创新中心资助项目(No:19Z14)
四川省医学会高血压(施慧达)专项科研课题(No:2016SHD013)
成都医学院第一附属医院独立资助课题(No:CYFY16DL-06)。
关键词
维持性血液透析
血管钙化
镁
Maintenance hemodialysis
Vascular calcification
Magnesium
