【摘要】 目的 分析血浆可溶性晚期糖基化终末产物受体（s RAGE）表达水平与维持性血液透析（MHD）患者全因死亡的关系。方法 选择血液透析中心行MHD的患者119例为研究对象，根据患者血浆sRAGE表达中位数将MHD患者分为sRAGE高水平组（>3.51 ng/ml）59例，s RAGE低水平组（≤3.51 ng/ml）60例。比较两组的血清白蛋白（ALB）、血红蛋白（Hb）、高敏C反应蛋白（hs-CRP）等指标变化；采用Kaplan-Meier曲线分析血浆sRAGE表达与累积生存率的关系；采用COX回归分析MHD患者全因死亡的影响因素。结果 sRAGE低水平组血清ALB水平高于sRAGE高水平组，血清hs-CRP水平低于sRAGE高水平组，差异均有统计学意义（t=3.83,Z=4.34,P均<0.05）。Kaplan-Meier生存分析显示，sRAGE低水平组累积生存率为82.76%，高于sRAGE高水平组的58.18%（χ~2=7.73,P<0.05）。COX多因素分析显示，sRAGE、ALB、hs-CRP是MHD患者全因死亡的影响因素（HR分别=1.58、0.64、1.31,P均<0.05）。结论 血浆sRAGE水平与MHD患者全因死亡有关，其水平升高是影响MHD患者全因死亡独立危险因素。更多还原

【Abstract】 Objective To analyze the relationship between the expression level of plasma soluble receptor for advanced glycation end products(sRAGE)and all-cause mortality in maintenance hemodialysis(MHD)patients. Methods A total of 119 patients who underwent MHD in the hemodialysis center were selected as the research objects,and they were divided into high-level sRAGE group(>3.51 ng/ml)with 59 cases and low-level sRAGE group（≤3.51 ng/ml）with 60 cases according to the median expression of plasma s RAGE.The changes of serum albumin(ALB),hemoglobin(Hb),and hyper sensitivity C-reactive protein(hs-CRP)were compared between the two groups.Kaplan-Meier curve was used to analyze the relationship between plasma s RAGE expression and cumulative survival rate,COX regression was used to analyze the influencing factors of all-cause mortality in MHD patients. Results The level of serum ALB in lowlevel s RAGE group was higher than that in high-level sRAGE group,and the level of serum hs-CRP was lower than that in high-level s RAGE group(t=3.83,Z=4.34,P<0.05).Kaplan-Meier survival analysis showed that the cumulative survival rate of low-level sRAGE group was 82.76%,which was higher than 58.18% of high-level sRAGE group（χ~2=7.73,P<0.05）.COX multivariate analysis showed that sRAGE,ALB and hs-CRP were the influencing factors of all-cause death in MHD patients(HR=1.58,0.64,1.31,P<0.05). Conclusion Plasma s RAGE level is related to all-cause mortality in MHD patients,and its elevated level is an independent risk factor affecting all-cause mortality in MHD patients.更多还原