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在接受维持血液透析的中国患者中冠状动脉化风险因素:元分析

Mengjiao Li¹, Yuxia Li², Shuting Liu¹

¹Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai, 201203, China.

International urology and nephrology

|May 2, 2025

概括

糖尿病和高副甲状腺激素水平是中国维护血液透析患者冠状动脉化的主要危险因素. 监测这些和其他因素可以帮助预防心血管疾病的进展.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
心脏病学心脏病学
公共卫生公共卫生

背景情况:

慢性病 (CKD) 进展为末期病 (ESRD) 显著增加心血管疾病 (CVD) 风险.
冠状动脉化 (CAC) 影响了大多数中国维持血液透析 (MHD) 患者,由长时间透析和矿物不平衡加剧.
由于方法上的差异,现有的关于MHD患者中CAC风险因素的研究缺乏共识.

研究的目的:

系统地分析与冠状动脉化 (CAC) 相关的风险因素,在接受维持血液透析 (MHD) 的中国患者中.

主要方法:

进行了对24项观察性研究 (队列,病例控制,横截面) 的综合元分析,涉及2875名中国MHD患者.
通过对10个数据库进行系统搜索,直到2024年10月21日,根据PRISMA指南确定了研究.
风险因素使用几率比率 (ORs) 和95%信心区间 (CI) 进行评估,研究质量通过纽卡斯尔-太华尺度进行评估.

主要成果:

糖尿病 (OR=2.32) 和提升的完整副甲状腺激素 (iPTH) (OR=1.59) 成为中国MHD患者中CAC最强的预测因素.
其他重要的预测因素包括高灵敏度C反应蛋白 (hs-CRP),血清,晚年,更长的透析时间,血清和硬质素 (SOST).
在CAC和高血压,血清,FGF-23或ALP之间没有发现显著的相关性,可能是由于研究异质性.

结论:

糖尿病和IPTH升高是中国MHD患者中CAC的临床危险因素,需要专注的临床关注.
监测-代谢和炎症标志物 (hs-CRP,SOST) 对于减轻心血管疾病风险至关重要.
对高风险的MHD患者实施早期健康教育和量身定制的治疗策略可以预防和延迟CAC的发展和进展.

关键词:

冠状动脉的化和化维护血液透析的维护血液透析.进行元分析分析.风险因素风险因素

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