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应用超声心动图钙评分评估腹膜透析患者心脏钙化与心血管疾病的关系:一项横断面研究。

Evaluation of the relationship between cardiac calcification and cardiovascular disease using the echocardiographic calcium score in patients undergoing peritoneal dialysis: a cross-sectional study.

机构信息

Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong.

出版信息

Singapore Med J. 2023 Jun;64(6):379-384. doi: 10.11622/smedj.2022052.

Abstract

INTRODUCTION

An echocardiographic calcium score (ECS) predicts cardiovascular disease (CVD) in the general population. Its utility in peritoneal dialysis (PD) patients is unknown.

METHODS

This cross-sectional study assessed 125 patients on PD. The ECS (range 0-8) was compared between subjects with CVD and those without.

RESULTS

Among the subjects, 54 had CVD and 71 did not. Subjects with CVD were older (69 years vs. 56 years, P < 0.001) and had a higher prevalence of diabetes mellitus (DM) (81.5% vs. 45.1%, P < 0.001). They had lower diastolic blood pressure (72 mmHg vs. 81 mmHg, P < 0.001), lower phosphate (1.6 mmol/L vs. 1.9 mmol/L, P = 0.002), albumin (30 g/L vs. 32 g/L, P = 0.001), parathyroid hormone (34.4 pmol/L vs. 55.8 pmol/L, P = 0.002), total cholesterol (4.5 vs. 4.9, P = 0.047), LDL cholesterol (2.4 mmol/L vs. 2.8 mmol/L, P = 0.019) and HDL cholesterol (0.8 mmol/L vs. 1.1 mmol/L, P = 0.002). The ECS was found to be higher in subjects with CVD than in those without (2 vs. 1, P = 0.001). On multivariate analysis, only DM and age were independently associated with CVD.

CONCLUSION

The ECS was significantly higher in PD patients with CVD than in those without, reflecting a higher vascular calcification burden in the former. It is a potentially useful tool to quantify vascular calcification in PD patients.

摘要

简介

超声心动图钙评分(ECS)可预测普通人群的心血管疾病(CVD)。其在腹膜透析(PD)患者中的应用尚不清楚。

方法

本横断面研究评估了 125 名 PD 患者。比较了 CVD 患者和非 CVD 患者的 ECS(范围 0-8)。

结果

在研究对象中,54 人患有 CVD,71 人没有。患有 CVD 的患者年龄较大(69 岁 vs. 56 岁,P < 0.001),且糖尿病(DM)患病率较高(81.5% vs. 45.1%,P < 0.001)。他们的舒张压(72 mmHg vs. 81 mmHg,P < 0.001)、血磷(1.6 mmol/L vs. 1.9 mmol/L,P = 0.002)、白蛋白(30 g/L vs. 32 g/L,P = 0.001)、甲状旁腺激素(34.4 pmol/L vs. 55.8 pmol/L,P = 0.002)、总胆固醇(4.5 vs. 4.9,P = 0.047)、低密度脂蛋白胆固醇(2.4 mmol/L vs. 2.8 mmol/L,P = 0.019)和高密度脂蛋白胆固醇(0.8 mmol/L vs. 1.1 mmol/L,P = 0.002)均较低。患有 CVD 的患者的 ECS 高于没有 CVD 的患者(2 分 vs. 1 分,P = 0.001)。多变量分析显示,只有 DM 和年龄与 CVD 独立相关。

结论

与没有 CVD 的患者相比,PD 合并 CVD 的患者的 ECS 明显更高,反映了前者的血管钙化负担更高。它是一种定量评估 PD 患者血管钙化的潜在有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39fc/10335638/d5be20592bf7/SMJ-64-379-g001.jpg

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