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终末期肾病血液透析患者中心血管和非心血管死亡风险因素的性别依赖性影响

Gender-dependent impact of risk factors for cardiovascular and non-cardiovascular mortality in end-stage renal disease patients on haemodialysis.

作者信息

Hocher Berthold, Kalk Philipp, Godes Michael, Liefeldt Lutz, Ziebig Reinhard, Stasch Johannes-Peter, Quaschning Thomas, Pfab Thiemo

机构信息

Center for Cardiovascular Research/Department of Pharmacology, Charité, Berlin, Germany.

出版信息

Kidney Blood Press Res. 2008;31(5):360-6. doi: 10.1159/000173718. Epub 2008 Nov 20.

Abstract

We investigated whether mortality risk factors are gender dependent in haemodialysis patients. Patients (n = 230; 118 women, 112 men) on haemodialysis were followed for 52 months to assess the incidence of death due to cardiovascular or non-cardiovascular causes. Survival was compared by Cox regression analysis using age, diabetes, pre-existing coronary disease, troponin T and C-reactive protein as covariates. In total, 120 participants (52.2%) died within the 52 months of follow-up: 57 patients died of cardiovascular disease, 35 patients died of infectious diseases. Cox regression revealed that age, pre-existing coronary heart disease and troponin T were independent all-cause mortality risk factors for both sexes. Analyzing men and women separately revealed that diabetes and C-reactive protein seemed to be a stronger risk factors for all-cause mortality in women. Cardiovascular mortality was predicted by troponin T in women (relative risk = 5.16, 95% CI: 1.67-15.88; p = 0.004), but not in men (relative risk = 1.69; 95% CI: 0.72-3.96; p = 0.23). Our study showed for the first time that the impact of risk factors in predicting death due to cardiovascular disease is clearly gender dependent.

摘要

我们调查了血液透析患者的死亡风险因素是否存在性别差异。对230例接受血液透析的患者(118名女性,112名男性)进行了52个月的随访,以评估心血管或非心血管原因导致的死亡发生率。使用年龄、糖尿病、既往冠心病、肌钙蛋白T和C反应蛋白作为协变量,通过Cox回归分析比较生存率。在总共52个月的随访期内,共有120名参与者(52.2%)死亡:57例死于心血管疾病,35例死于传染病。Cox回归显示,年龄、既往冠心病和肌钙蛋白T是两性全因死亡的独立风险因素。分别对男性和女性进行分析发现,糖尿病和C反应蛋白似乎是女性全因死亡的更强风险因素。肌钙蛋白T可预测女性的心血管死亡率(相对风险=5.16,95%置信区间:1.67-15.88;p=0.004),但不能预测男性的心血管死亡率(相对风险=1.69;95%置信区间:0.72-3.96;p=0.23)。我们的研究首次表明,风险因素在预测心血管疾病导致的死亡方面的影响明显存在性别差异。

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