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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Bibliographic Details
Published in复旦学报（医学版） Vol. 44; no. 4; pp. 447 - 452
Main Author 顾佳芸 沈波 吴炯 戴谦 曹旻璐 陈曦旻 郭玮 潘柏申
Format Journal Article
LanguageChinese
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
Subjects
危险分级
维持性血液透析
超敏肌钙蛋白
预后评估
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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ISSN1672-8467
DOI10.3969/j.issn.1672-8467.2017.04.009

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Summary: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。
Bibliography: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
ISSN:1672-8467
DOI:10.3969/j.issn.1672-8467.2017.04.009