【摘要】 目的探讨血清骨保护素(OPG)、碱性磷酸酶(ALP)及N末端脑钠肽前体(NT-proBNP)对维持性血液透析(MHD)患者并发心血管疾病(CVD)的预测价值。方法选取2018年1月至2019年6月行MHD治疗的140例患者为MHD组,其中51例并发CVD患者为CVD组,89例未并发CVD患者为无CVD组,另选取80例健康体检者为健康组。检测各组血清OPG、ALP及NT-proBNP水平,Logistic回归分析MHD患者并发CVD的危险因素,绘制受试者工作特征(ROC)曲线分析各项指标预测MHD患者并发CVD的价值。结果MHD组血清OPG、ALP及NT-proBNP水平明显高于健康组,CVD组血清OPG、ALP及NT-proBNP水平高于无CVD组,差异有统计学意义(P<0.05)。透析龄<72个月和透析龄≥72个月CVD患者血清OPG、ALP及NT-proBNP水平比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,透析龄长,OPG、ALP及NT-proBNP升高是导致MHD患者并发CVD的独立危险因素(P<0.05)。血清OPG、ALP及NT-proBNP预测MHD患者并发CVD的ROC曲线下面积分别为0.869、0.881、0.864。结论血清OPG、ALP及NT-proBNP升高是MHD患者并发CVD的重要危险因素,3项指标均对预测MHD患者并发CVD具有一定参考价值。更多还原

【Abstract】 Objective To investigate the predictive value of serum osteoprotegerin(OPG),alkaline phosphatase(ALP)and N-terminal brain natriuretic peptide precursor(NT-proBNP)in patients with maintenance hemodialysis(MHD)complicated with cardiovascular disease(CVD).Methods A total of 140 patients who received MHD treatment from January 2018 to June 2019 were selected into MHD group,among them,51 patients with concurrent CVD were in CVD group,89 patients without concurrent CVD were in non-CVD group,and other 80 healthy subjects were selected as healthy group.Serum OPG,ALP and NT-proBNP levels were detected in each group.The risk factors of MHD patients complicated with CVD were explored by Logistic regression analysis.The value of each indicator in predicting MHD patients complicated with CVD was analyzed by receiver operation characteristic(ROC)curve.Results The levels of OPG,ALP and NT-proBNP in MHD group were significantly higher than those in healthy group(P<0.05).The levels of OPG,ALP and NTproBNP in CVD group were higher than those in non-CVD group(P<0.05).There was no statistically significant difference on serum OPG,ALP and NT-proBNP levels between CVD patients with dialysis ages<72 months years and CVD patients with dialysis ages ≥ 72 months(P >0.05).Logistic regression analysis showed that the long time dialysis,elevated OPG,ALP and NT-proBNP were independent risk factors for CVD in MHD patients(P<0.05).The areas under ROC of serum OPG,ALP and NT-proBNP in predicting MHD patients with CVD were 0.869,0.881 and 0.864 respectively.Conclusion Elevated serum OPG,ALP and NT-proBNP are important influencing factors for MHD patients with concurrent CVD,and the three factors have certain reference value for predicting MHD patients with concurrent CVD.更多还原