【摘要】 目的 分析老年维持性血液透析(MHD)病人心脏瓣膜钙化(CVC)的相关因素。方法 选择2022年6—9月在扬中市人民医院血液净化中心治疗的104例老年MHD病人为研究对象，依据瓣膜钙化情况分为CVC组(45例)和非CVC组(59例),比较2组的基线资料、血管内皮功能、冠状动脉钙化程度以及心脏结构与功能。采用多因素Logistic回归分析老年MHD病人发生CVC的危险因素。结果 CVC组年龄、冠状动脉钙化总分、冠状动脉左主干和右冠状动脉钙化积分、舒张末左室后壁厚度、舒张末室间隔厚度、左心室质量指数均显著高于非CVC组，肱动脉血流介导的内皮依赖性舒张功能(FMD)明显小于非CVC组，差异有统计学意义；多因素Logistic回归显示：年龄增长(OR=1.121,95%CI:1.025～1.227)和FMD降低(OR=0.879,95%CI:0.791～0.978)是老年MHD病人发生CVC的危险因素(均P<0.05)。结论 年龄增长和FMD减退与老年MHD病人发生CVC相关，临床中通过检测FMD可能有助于早期识别、预警CVC的发生。更多还原

【Abstract】 Objective To analyze the influencing factors of cardiac valve calcification(CVC) in the elderly patients receiving maintenance hemodialysis(MHD). Methods A total of 104 elderly MHD patients treated at the Blood Purification Center of Yangzhong People’s Hospital from June to September 2022 were selected as the study subjects. Based on the presence of CVC, they were divided into CVC group(45 cases) and non-CVC group(59 cases). Baseline data, vascular endothelial function, coronary artery calcification scores, and cardiac structure and function were compared between the two groups. Logistic regression analysis was used to identify the risk factors for CVC in the elderly MHD patients. Results Age, total score of coronary artery calcification, left main coronary artery and right coronary artery calcification score, post-diastolic left ventricular wall thickness, post-diastolic ventricular septal thickness and left ventricular mass index in CVC group were significantly higher and brachial arterial flow-mediated dilatation(FMD) in CVC group was significantly lower than those in non-CVC group. Multivariate Logistic regression analysis showed that aging(OR=1.121,95%CI:1.025-1.227)and the level of FMD(OR=0.879,95%CI:0.791-0.978) were the related factors for CVC in the elderly MHD patients(All P<0.05). Conclusions Aging and the decline of FMD are risk factors for CVC in the elderly MHD patients. Detection of FMD may be helpful for early identification and early warning of CVC.更多还原