目的 研究维持性血液透析(MHD)患者血清碱性磷酸酶(ALP)对其心脏病变的评估价值。方法 回顾性分析2017-01至2019-10在空军特色医学中心接受规律血液透析治疗的98例患者临床资料,按照患者ALP水平差异将其分为,ALP升高组(＞120 U/L)和正常ALP组(≤120 U/L),每组49例。同时化验血清白蛋白(ALB)、血红蛋白(Hb)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血清三酰甘油(TG)、血清总胆固醇(TC)、C反应蛋白(CRP)、血钙(Ca)、血磷(P)、全段甲状旁腺激素(iPTH)等指标,完善心脏彩超及颈动脉中膜厚度(intima-media thickness, IMT)检查,比较两组患者相关辅助检查结果,分析上述化验结果对心脏病变的影响。结果 两组患者ALB、Hb、HDL、LDL、TG、TC等指标之间,无统计学差异,两组患者CRP、Ca、P、iPTH、左心室射血分数(LVEF)、舒张早期充盈最大峰值速度/舒张晚期充盈最大峰值速度(E/A)、左房增大、左室扩大、颈动脉斑块发生、心脏瓣膜钙化及颈动脉IMT之间差异有统计学意义(P<0.05)。相关性分析表明,ALP、CRP、P、Ca、颈动脉IMT与心脏病变相关;多因素回归分析显示,ALP水平是心脏病变的独立影响因素(P<0.05)。结论 MHD患者的ALP水平对评估其心脏病变的情况有较高的临床价值。
Abstract
Objective To study the value of serum alkaline phosphatase(ALP) in the assessment of heart disease among maintenance hemodialysis patients. Methods The clinical data on 98 patients who received regular hemodialysis treatment in Air Force Medical Center between January 2017 and October 2019 was retrospectively analyzed. According to ALP levels, the patients were divided into the elevated ALP group (>120 U/L) and normal ALP group (≤120 U/L), with 49 patients in each. Meanwhile, levels of serum albumin (ALB), hemoglobin (HB), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC), C-reactive protein (CRP), blood calcium (CA), blood phosphorus (P), intact parathyroid hormone (iPTH) and other indicators were tested. The cardiac color Doppler ultrasound was used and the carotid artery intima-media thickness was examined. The difference in the results of related auxiliary examinations between the two groups was observed, while the effects of the above test results on cardiac lesions were analyzed. Results There was no significant difference in levels of ALB, HB, HDL, LDL, TG or TC between the two groups (P>0.05). However, there was significant difference in levels of CRP, CA, P, iPTH, LVEF, maximum peak velocity of early diastolic filling/maximum peak velocity of late diastolic filling (E/A), left atrial enlargement, left ventricular enlargement, carotid plaque, cardiac valve calcification and carotid IMT between the two groups (P<0.05). Correlation analysis showed that ALP, CRP, P, Ca and carotid IMT were related to heart disease. Multivariate regression analysis indicated that ALP levels were an independent influencing factor of heart disease (P<0.05). Conclusions Levels of ALP in MHD patients are of high clinical value for assessing the severity of heart disease.
关键词
碱性磷酸酶 /
维持性血液透析 /
颈动脉内膜中层厚度 /
心脏病变
Key words
alkaline phosphatase /
maintenance hemodialysis /
carotid intima-media thickness /
heart disease
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