应用腰椎侧位片评价血液透析患者腹主动脉钙化

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1、万方数据应用腰椎侧位片评价血液透析患者腹主动脉钙化陈孜瑾陈晓农马晓波侯亮丁蓓凌华威李晓任红陈楠【摘要】目的应用x线平片腹主动脉钙化评分探讨维持性血液透析(MHD)患者腹主动脉钙化患病率和相关危险因素分析。方法选取我院资料完整的155例MHD患者为研究对象。通过x线腰椎侧位片检测腹主动脉钙化(AAC)并对其进行评分。结果155例的腰椎侧位片中，腹主动脉钙化主要发生在第4腰椎节段，并随着节段的上升而逐渐减少。63．63％患者的侧位平片上可见腹主动脉钙化；28．39％患者可见严重腹主动脉钙化(钙化累及3个节段以上)。MHD患者的年龄(OR=1．094，P<

2、0．01)、透析龄(OR=1．013，P=0．022)、血三酰甘油(OR=1．261，P=0．030)和血磷(OR=1．324，P=0．023)水平是发生腹主动脉钙化的独立危险因素，而白蛋白(OR=0．239，P=0．013)为保护性因素。结论MHD患者腹主动脉钙化患病率高，且与多个血管钙化因素相关。半定量的x线腰椎侧位片方法价格便宜、操作简便，易于临床推广。其对MHD患者的预测价值有待日后更多的随访研究。【关键词】血液透析；钙质沉着症；心血管疾病；腰椎侧位片Abdominalaorticcalcificationdetectedbylaterall

3、umbarX-rayinmaintenancehemodialysispatientsCHENZi-jin，CHENXiao-nong,MAXiao—bo，HOULiang,DINGBei，LINGHna-wei，LIXiao，RENHong,CHENNan．DepartmentofNephrology，RuijinHospital，sh∞lg瓶JiaotongUniversitySchoolofMedicine，Shanghai200025，ChinaCorrespondingauthor：CHENNan。Entail：chen—nan@medma

4、il．corn．cn【Abstract】objectiveToexploretheincidenceandassociatedfactorsofaorticarterycalcification(AAC)bylaterallumbarX-rayscoreinmaintenancehemodialysis(MHD)patients．MehtodsAtotalof155MHDpatientswithcompleteclinicaldatainourhospitalwefeenrolledintIIestudy．LaterallumbarX．rayscor

5、eoftlleabdominalaortawasusedtodetermineAACinMHDpatients．ResultsAortictalcificafionW／ISmostsevereinfrontofthefourthIumbarsegmentandamelioratedinhisherlumbarlevels．63．63％ofMHDpafienmpresentedvisiblecalcificationintheabdominalaorta．and28．39％had8evelt℃calcificationwithmorethanthree

6、segments．Age(OR=1．094，P<0．01)，dialysisvintage(0R=1．013，P=O．022)，triglyceride(OR=1．261，P=O．030)andphosphateIevel(OR=1．324，P=0．023)wereriskfactorsofabdominalaortacalcification，howeverserumalbuminlevel(OR=O．239，P=0．013)w弱protectfactorofaorticealc-ification．ConclusionsIncidenceofAA

7、CisquitehishinMHDpatientsandassociatedwitllincreasingofage，durationofhemodialysis，serunltriglyceride，phosphatelevelandplasmaalbumin．而esemi·quantitativeX．raymethodofdeterminingvascularcalcificationislessexpensiveandmaybewidelyavailableclinically．【Keywords】Hemadialysis；Calcinosis

8、；Cardiovasculardiseases；LaterallumbarradiographyDOI：10