摘要
目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者多频生物电阻抗指标与心血管事件的关系。方法选择126例MHD患者作为研究对象,根据透析期间是否发生心血管事件将其分为心血管事件组(36例)和对照组(90例)。两组均行多频生物电阻抗检查,并获取相关参数[相位角、细胞外液/细胞内液(extracellular water/intracellular water,ECW/ICW)、瘦体组织指数(lean tissue index,LTI)、体液超负荷值(over-hydration,OH)]。比较两组基线资料、实验室指标及多频生物电阻抗各指标。采用点二列相关性分析探讨多频生物电阻抗各指标与MHD患者心血管事件的关系。利用ROC曲线分析多频生物电阻抗各指标对心血管事件发生风险的预测价值。结果126例患者中,发生冠心病16例、心力衰竭12例、心律失常8例:心血管事件发生率28.57%(36/126)。心血管事件组透析不充分患者占比、ECW/ICW、OH值均明显高于对照组(均P<0.01),相位角、LTI值明显低于对照组(均P<0.01)。经点二列相关性分析,MHD患者心血管事件发生率与相位角、LTI呈负相关,与ECW/ICW、OH呈正相关(均P<0.01)。ROC曲线分析显示,相位角、ECW/ICW、LTI、OH单独及联合预测MHD患者心血管事件发生风险的AUC值分别为0.853、0.878、0.866、0.856和0.944,均具有良好的预测价值。结论MHD患者多频生物电阻抗各指标与心血管事件的发生密切相关,且多频生物电阻抗各指标对心血管事件的发生具有一定的预测价值。
Objective To explore the relationship between parameters of multifrequency bioelectrical impedance and cardiovascular events in maintenance hemodialysis(MHD)patients.Methods A total of 126 MHD patients were selected as study subjects,and divided into a cardiovascular event group(36 cases)and a control group(90 cases)based on the occurrence of cardiovascular events during hemodialysis.Both groups underwent multifrequency bioelectrical impedance testing;we obtained relevant parameters[phase angle,extracellular water/intracellular water(ECW/ICW),lean tissue index(LTI),and over-hydration(OH)].Baseline data,laboratory indicators,and multifrequency bioelectrical impedance parameters were compared between the two groups.Point-biserial correlation analysis was used to explore the relationship between multifrequency bioelectrical impedance parameters and cardiovascular events in MHD patients.ROC curve analysis was employed to evaluate the predictive value of these parameters for the risk of cardiovascular events.Results Among the 126 patients,there were 16 cases of coronary heart disease,12 cases of heart failure,and 8 cases of arrhythmia,resulting in a cardiovascular event incidence of 28.57%(36/126).The proportion of patients with inadequate hemodialysis,ECW/ICW,and OH values were all significantly higher in the cardiovascular event group compared to the control group(all P<0.01),while phase angle and LTI values were significantly lower(all P<0.01).Point-biserial correlation analysis revealed that the incidence of cardiovascular events in MHD patients was negatively correlated with phase angle and LTI,and positively correlated with ECW/ICW and OH(all P<0.01).ROC curve analysis showed that the AUC value for phase angle,ECW/ICW,LTI,OH individually and in combination for predicting the risk of cardiovascular events in MHD patients were 0.853,0.878,0.866,0.856,and 0.944,respectively,indicating good predictive value.Conclusion Various parameters of multifrequency bioelectrical impedance are closely related to the occurrence of cardiovascular events in MHD patients,and thus have certain predictive value for such events.
作者
张利
董寅迪
ZHANG Li;DONG Yindi(Department of Nephrology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471003,China)
出处
《实用心电与临床诊疗》
2025年第6期849-854,共6页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
基金
河南省医学科技攻关计划项目(LHGJ20220669)。
关键词
维持性血液透析
多频生物电阻抗
心血管事件
预测
maintenance hemodialysis
multifrequency bioelectrical impedance
cardiovascular event
prediction
