维持性腹膜透析患者腹主动脉钙化进展的危险因素分析

【摘要】 目的 探讨维持性腹膜透析（MPD）患者腹主动脉钙化（AAC）的进展情况及其影响因素。方法 回顾性纳入2021年11月至2024年12月在医院随访的MPD患者。收集患者随访期间两次侧位腹部平片检查的AAC评分（AAC Score）及人口学、血清学资料。根据年度AAC评分平均增长量，将患者分为快速进展组（n=64）与缓慢进展组（n=193），进行单因素和多因素Logistic回归分析。结果 共纳入257例患者。基线时AAC发生率为55.6%(135/257),AAC评分为1(0,5)分。中位随访29个月期间，AAC发生率增至68.9%(177/257),AAC评分为3(0,9)分。43例（16.7%）为新发AAC,134例（52.1%）出现AAC进展。多因素Logistic回归分析显示，年龄（OR=1.037,95%CI:1.011～1.063,P=0.004）与时间平均hs-CRP水平（OR=1.028,95%CI:1.002～1.054,P=0.035）是AAC快速进展的独立危险因素。结论 年龄与hs-CRP水平是MPD患者AAC快速进展的独立危险因素。临床中应重视监测并干预hs-CRP水平，以延缓AAC进展。更多还原

【Abstract】 Objective To investigate the progression of abdominal aortic calcification(AAC) and its influencing factors in patients on maintenance peritoneal dialysis(MPD). Methods This retrospective study enrolled MPD patients who were followed up at Hangzhou Hospital of Traditional Chinese Medicine from November 2021 to December 2024.Data collected included AAC scores(AACs) from two lateral abdominal plain radiographs during followup, as well as demographic and serological parameters. Based on the annual average increase in AACs, patients were divided into a rapid progression group(n=64) and a slow progression group(n=193). Univariate and multivariate Logistic regression analyses were performed. Results A total of 257 patients were included. At baseline, the prevalence of AAC was 55.6%(135/257), with a median AACs of 1(0, 5) points. During a median follow-up of 29 months, the prevalence of AAC increased to 68.9%(177/257), with a median AACs of 3(0, 9) points. New-onset AAC occurred in 43 patients(16.7%), and AAC progression was observed in 134 patients(52.1%). Multivariate Logistic regression analysis identified age(OR=1.037, 95% CI: 1.011～1.063, P=0.004) and time-averaged high-sensitivity C-reactive protein(hs-CRP) level(OR=1.028, 95% CI: 1.002～1.054, P=0.035) as independent risk factors for rapid AAC progression. Conclusion Age and hs-CRP level are independent risk factors for rapid AAC progression in MPD patients. Clinical attention should be given to monitoring and managing hs-CRP levels to delay AAC progression.更多还原