尿酸、脂联素与水肿指数对腹膜透析患者主要不良心血管事件的预测价值

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中图分类号：R692.5 文献标志码：A DOI：10.11958/20252525

Abstract：ObjectiveTo explore the predictive value ofuric acid（UA），adiponectin（APN）and edema index formajor adverse cardiovascular events （MACE） in peritoneal dialysis （PD）patients.MethodsEighty patients who underwent PD treatment were selected as the study group，andanother 3O healthy individuals who underwent physical examinationduring the same period were selected as the control group.The serum levels of UA，APNand the edema index were compared between the two groups.Patients were divided into the MACE group（ n =22）and thenon-MACE group（ n =58）based on whether MACE occurred，andthe relationship between serum UA，APNand edema index andthe occuirence ofMACE in PD patients was analyzed.ROC curve was established to evaluatethe predictive value of serum UA，APNand edema index for the occurrenceof MACE inPDpatients.ResultsThe serumlevelsofUA，APNand theedema index wereall higherinthe study group than those in the control group （all P<0.01 ）.Theserum levelsofUA and APNwere both positively correlated with the edema index of PD patients （r=0.456， 0.341， P<0.01 ）. The serum UA level and edema index were significantly higherinthe MACE groupthan those inthe non-MACEgroup，and the serumAPNlevelwas significantlylowerthanthat in the non-MACE group （all P<0.01 ）.The serum UA level and edema index were positively correlated with the occurrence of MACE in PD patients （ Σ′s =0.438，0.465， P<0.001 ）. The serum level of APN was negatively correlated with the occurrence of MACEin PD patients （rs=-0.447， P<0.001 ）.Thearea under the curve（AUC）ofserum UA，APN and edema index in predicting MACE inPDpatients were0.709 （95%CI： 0.586-0.833），0.771（95%CI： 0.649-0.892）and0.722（95%CI： 0.596- 0.848），respectively.TheAUCof thecombined predictionofthethree was0.944（95%Cl： 0.890-0.998）.ConclusionThe serumlevelsof UA，APNandedemaindexare increasedinPDpatients.Alltethreearerelated totheoccurrenceofMACE. The combined detection hasahigher predictive efficacy for MACE.

Key words：peritoneal dialysis，continuous ambulatory;uricacid;adiponectin; edema index; majoradversecardiovasculai events

腹膜透析（peritonealdialysis，PD）是终末期肾脏疾病患者临床治疗中不可或缺的肾脏替代疗法之一，其主要是通过半透膜原理来有效清除机体内蓄积的代谢终产物及过量液体，在延长患者生存期的同时显著提升其生活质量[1-2]。（剩余9634字）