超敏肌钙蛋白对维持性血液透析患者的短期预后作用
目的探讨超敏肌钙蛋白（high-sensitivity cardiac troponin T,hs-cTnT）对维持性血液透析（maintainance hemodialysis,MHD）患者的短期预后作用。方法 入组296例MHD患者,回顾性分析其临床资料,患者血液透析前采集血清检测hs-cTnT和相关心血管风险标志物。随访时间总长为13个月,记录主要终点事件（全因死亡）及发生时间;用t检验、Mann-Whitney U检验和χ2检验分析比较全因死亡与生存组风险标志物之间的差异,使用X-tile计算出hs-cTnT的最佳二分位切点,绘制Kaplan-Meier生存曲线,用Logistic回归...
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| Published in | 复旦学报（医学版） Vol. 44; no. 4; pp. 447 - 452 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
复旦大学附属中山医院检验科 上海200032%复旦大学附属中山医院肾内科 上海200032
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1672-8467 |
| DOI | 10.3969/j.issn.1672-8467.2017.04.009 |
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| Abstract | 目的探讨超敏肌钙蛋白（high-sensitivity cardiac troponin T,hs-cTnT）对维持性血液透析（maintainance hemodialysis,MHD）患者的短期预后作用。方法 入组296例MHD患者,回顾性分析其临床资料,患者血液透析前采集血清检测hs-cTnT和相关心血管风险标志物。随访时间总长为13个月,记录主要终点事件（全因死亡）及发生时间;用t检验、Mann-Whitney U检验和χ2检验分析比较全因死亡与生存组风险标志物之间的差异,使用X-tile计算出hs-cTnT的最佳二分位切点,绘制Kaplan-Meier生存曲线,用Logistic回归分析高危及非高危hs-cTnT之间的死亡风险比。根据hs-cTnT健康人群第99百分位点将非高危组细分为中危组和低危组来进一步评估其对MHD患者短期预后的影响。结果 MHD患者生存与全因死亡组的血清hs-cTnT水平分别为0.05（0.03~0.07）ng/mL和0.07（0.04~0.14）ng/mL（P=0.027）;hs-cTnT的最佳二分位切点为0.1 ng/mL;高危组（hs-cTnT〉0.1 ng/mL）患者生存率（76.67%）显著低于非高危组（hs-cTnT≤0.1 ng/mL）患者生存率（96.62%）（P〈0.05）;高危组患者死亡风险较非高危组患者高7.288倍（P〈0.001）;在非高危人群组中,中危组（hs-cTnT〉0.014 ng/mL）患者生存率低于低危组（hs-cTnT≤0.014 ng/mL）患者生存率,低危组在随访期间无死亡事件发生。结论 hs-cTnT是MHD患者死亡的独立危险因素,并可作为MHD患者短期的死亡风险分级和预后评估的有力指标。 |
|---|---|
| AbstractList | R459.5%R446; 目的 探讨超敏肌钙蛋白(high-sensitivity cardiac troponin T,hs-cTnT)对维持性血液透析(maintainance hemodialysis,MHD)患者的短期预后作用.方法 入组296例MHD患者,回顾性分析其临床资料,患者血液透析前采集血清检测hs-cTnT和相关心血管风险标志物.随访时间总长为13个月,记录主要终点事件(全因死亡)及发生时间;用t检验、Mann-Whitney U检验和x2检验分析比较全因死亡与生存组风险标志物之间的差异,使用X-tile计算出hscTnT的最佳二分位切点,绘制Kaplan-Meier生存曲线,用Logistic回归分析高危及非高危hs-cTnT之间的死亡风险比.根据hs-cTnT健康人群第99百分位点将非高危组细分为中危组和低危组来进一步评估其对MHD患者短期预后的影响.结果 MHD患者生存与全因死亡组的血清hs cTnT水平分别为0.05 (0.03～0.07)ng/mL和0.07(0.04～0.14)ng/mL (P=0.027);hs-cTnT的最佳二分位切点为0.1 ng/mL;高危组(hs-cTnT＞0.1 ng/mL)患者生存率(76.67％)显著低于非高危组(hs-cTnT≤0.1 ng/mL)患者生存率(96.62％)(P＜0.05);高危组患者死亡风险较非高危组患者高7.288倍(P＜0.001);在非高危人群组中,中危组(hs-cTnT＞0.014 ng/mL)患者生存率低于低危组(hs-cTnT≤0.014 ng/mL)患者生存率,低危组在随访期间无死亡事件发生.结论 hs-cTnT是MHD患者死亡的独立危险因素,并可作为MHD患者短期的死亡风险分级和预后评估的有力指标. 目的探讨超敏肌钙蛋白（high-sensitivity cardiac troponin T,hs-cTnT）对维持性血液透析（maintainance hemodialysis,MHD）患者的短期预后作用。方法 入组296例MHD患者,回顾性分析其临床资料,患者血液透析前采集血清检测hs-cTnT和相关心血管风险标志物。随访时间总长为13个月,记录主要终点事件（全因死亡）及发生时间;用t检验、Mann-Whitney U检验和χ2检验分析比较全因死亡与生存组风险标志物之间的差异,使用X-tile计算出hs-cTnT的最佳二分位切点,绘制Kaplan-Meier生存曲线,用Logistic回归分析高危及非高危hs-cTnT之间的死亡风险比。根据hs-cTnT健康人群第99百分位点将非高危组细分为中危组和低危组来进一步评估其对MHD患者短期预后的影响。结果 MHD患者生存与全因死亡组的血清hs-cTnT水平分别为0.05（0.03~0.07）ng/mL和0.07（0.04~0.14）ng/mL（P=0.027）;hs-cTnT的最佳二分位切点为0.1 ng/mL;高危组（hs-cTnT〉0.1 ng/mL）患者生存率（76.67%）显著低于非高危组（hs-cTnT≤0.1 ng/mL）患者生存率（96.62%）（P〈0.05）;高危组患者死亡风险较非高危组患者高7.288倍（P〈0.001）;在非高危人群组中,中危组（hs-cTnT〉0.014 ng/mL）患者生存率低于低危组（hs-cTnT≤0.014 ng/mL）患者生存率,低危组在随访期间无死亡事件发生。结论 hs-cTnT是MHD患者死亡的独立危险因素,并可作为MHD患者短期的死亡风险分级和预后评估的有力指标。 |
| Abstract_FL | Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T (hs-cTnT) and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis (MHD).Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed.Before MHD,hs-cTnT and other relative cardiovascular biomarkers were detected.The end point (all-cause death) and time of occurring were recorded in the next 13 months.The differences between survival and all-cause death were analyzed by t-test,Mann-Whitney test and x2 test.The best two percentile cutoff point was calculated by X-tile and the survival rate was calculated by Kaplan-Meier Logistic regression analysis was applied to analyze the odd ratio between high risk and non-high risk hs-cTnT group.Non-high risk group was divided into intermediate risk and low risk group based on the 99th percentile of hs-cTnT in healthy population,to further evaluate its short-term prediction value for MHD patients.The short-term significance of hs-cTnT was proved to be independently associated with all-cause death by Logistic regression analysis.Results The mean value of serum hs-cTnT in survival group was 0.05 (0.03～0.07) ng/mL,while in the death group it was 0.07 (0.04～0.14) ng/mL,which had statistical significance (P =0.027).The best two percentile cutoff of hs-cTnT in MHD patients was 0.1 ng/mL.The survival rate in high risk group (hs-cTnT＞0.1 ng/mL) is lower than it in non-high risk group (hs-cTnT≤0.1 ng/mL) (76.67％ vs.96.62％,P ＜0.05).The odd ratios for high risk group and non-high risk group was 7.288 (P＜ 0.001).Moreover,further grouping the non-high risk group by hs-cTnT =0.014 ng/mL,intermediate risk group (hs-cTnT＞0.014 ng/mL) group has lower survival rate than low risk group (hs-cTnT≤0.014ng/mL),while there wasn't any death case occurred in the low risk group.Conclusions Hs-cTnT is an independent risk factor to all-cause death.Thus hs-cTnT can be a strong indicator of short-term prediction and prognostic evaluation. |
| Author | 顾佳芸 沈波 吴炯 戴谦 曹旻璐 陈曦旻 郭玮 潘柏申 |
| AuthorAffiliation | 复旦大学附属中山医院检验科,上海200032 复旦大学附属中山医院肾内科,上海200032 |
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| Author_FL | WU Jiong GU Jia-yun GUO Wei CHEN Xi-min DAI Qian SHEN Bo PAN Bai-shen CAO Min-lu |
| Author_FL_xml | – sequence: 1 fullname: GU Jia-yun – sequence: 2 fullname: SHEN Bo – sequence: 3 fullname: WU Jiong – sequence: 4 fullname: DAI Qian – sequence: 5 fullname: CAO Min-lu – sequence: 6 fullname: CHEN Xi-min – sequence: 7 fullname: GUO Wei – sequence: 8 fullname: PAN Bai-shen |
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| Keywords | risk stratification 危险分级 maintenance hemodialysis 预后评估 超敏肌钙蛋白 prognostic evaluation high-sensitivity cardiac troponin T 维持性血液透析 |
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| Notes | GU Jia-yun1, SHEN Bo2 , WU Jiong1, DAI Qian1 , CAO Min-lu1 , CHEN Xi-min1, GUO Wei1, PAN Bai-shen1（1 Department of Clinical Laboratory Medicine, 2 Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai 200032, China） high-sensitivity cardiac troponin T; maintenance hemodialysis; risk stratification;prognostic evaluation Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T （hs-cTnT） and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis （MHD）. Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed. Before MHD, hs-cTnT and other relative cardiovascular biomarkers were detected. The end point （all-cause death） and time of occurring were recorded in the next 13 months. The differences between survival and all-cause death were analyzed by t-test, Mann-Whitney test and χ2 test. The best two percentile cutoff point was calculated by X-tile and the survival rate was calcul |
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| Publisher | 复旦大学附属中山医院检验科 上海200032%复旦大学附属中山医院肾内科 上海200032 |
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| Snippet | 目的探讨超敏肌钙蛋白（high-sensitivity cardiac troponin T,hs-cTnT）对维持性血液透析（maintainance hemodialysis,MHD）患者的短期预后作用。方法 入组296例MHD患者,回... R459.5%R446; 目的 探讨超敏肌钙蛋白(high-sensitivity cardiac troponin T,hs-cTnT)对维持性血液透析(maintainance hemodialysis,MHD)患者的短期预后作用.方法 入组296... |
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| SubjectTerms | 危险分级 维持性血液透析 超敏肌钙蛋白 预后评估 |
| Title | 超敏肌钙蛋白对维持性血液透析患者的短期预后作用 |
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