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血液透析合并感染性心内膜炎的危险因素及生存分析

Risk factors and survival analysis of haemodialysis complicated with infective endocarditis.

作者信息

He Ya-Jing, Ye Cun-Si, Xu Ke-Yang, Yang Li-Li, Wang Kai-Le, Wang Xiao-Mei, Li Mei-Yu, Wu Yu, Ying Qi-Su, Wang Ming, Quan Shi-Jian, Yang Xiu

机构信息

Department of Nephrology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, P.R. China.

School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 529000, P.R. China.

出版信息

Exp Ther Med. 2023 Mar 21;25(5):203. doi: 10.3892/etm.2023.11902. eCollection 2023 May.

DOI:10.3892/etm.2023.11902
PMID:37090071
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10119664/
Abstract

The clinical features and risk factors for survival time were analysed in haemodialysis patients complicated with infective endocarditis. A total of 101 infective endocarditis (IE) patients treated at Hangzhou First People's Hospital, from January 1, 2012, to April 1, 2022, were included in the present study. Baseline demographic data and laboratory data were collected for statistical analysis of risk factors and survival time in the IE with haemodialysis group (HD-IE group, n=15) and the IE without haemodialysis group (NHD-IE group, n=86). Haemoglobin, red blood cells, C-reactive protein, procalcitonin, serum albumin, diabetes, invasive procedures, positive blood bacteria culture, heart valve calcification ratio, and left ventricular ejection fraction level were risk factors for infective endocarditis complicated with haemodialysis (P<0.05). Compared with the NHD-IE group, the HD-IE group had an obviously increased risk of mortality (χ=6.323, P=0.012). The univariate Cox regression analysis showed that age, haemoglobin, red blood cells, serum albumin, left ventricular ejection score, longest vegetation diameter, combined hypotension and diabetes were risk factors for death; furthermore, multivariate Cox regression showed that age (HR=1.187, P=0.015), combined hypotension (HR=0.921, P=0.025) and the longest vegetation diameter (HR=9.191, P=0.004) were independent risk factors affecting the survival of patients. Collectively, the present study revealed that the mortality rate of HD-IE patients was higher than that of NHD-IE patients. Older age, hypotension, and the longest vegetation diameter were independent risk factors affecting the survival of patients. For HD-IE patients, active and effective antibiotic treatment or surgical treatment should be strongly recommended.

摘要

对合并感染性心内膜炎的血液透析患者的临床特征及生存时间的危险因素进行了分析。本研究纳入了2012年1月1日至2022年4月1日在杭州市第一人民医院接受治疗的101例感染性心内膜炎(IE)患者。收集了基线人口统计学数据和实验室数据,以对血液透析合并IE组(HD-IE组,n = 15)和非血液透析IE组(NHD-IE组,n = 86)的危险因素和生存时间进行统计分析。血红蛋白、红细胞、C反应蛋白、降钙素原、血清白蛋白、糖尿病、侵入性操作、血细菌培养阳性、心脏瓣膜钙化率和左心室射血分数水平是血液透析合并感染性心内膜炎的危险因素(P < 0.05)。与NHD-IE组相比,HD-IE组的死亡风险明显增加(χ = 6.323,P = 0.012)。单因素Cox回归分析显示,年龄、血红蛋白、红细胞、血清白蛋白、左心室射血评分、最长赘生物直径、合并低血压和糖尿病是死亡的危险因素;此外,多因素Cox回归显示,年龄(HR = 1.187,P = 0.015)、合并低血压(HR = 0.921,P = 0.025)和最长赘生物直径(HR = 9.191,P = 0.004)是影响患者生存的独立危险因素。总体而言,本研究表明HD-IE患者的死亡率高于NHD-IE患者。年龄较大、低血压和最长赘生物直径是影响患者生存的独立危险因素。对于HD-IE患者,应强烈推荐积极有效的抗生素治疗或手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/ebdf756b84ae/etm-25-05-11902-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/e02eda939dae/etm-25-05-11902-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/5ffdd4805445/etm-25-05-11902-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/ebdf756b84ae/etm-25-05-11902-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/e02eda939dae/etm-25-05-11902-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/5ffdd4805445/etm-25-05-11902-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1a4/10119664/ebdf756b84ae/etm-25-05-11902-g02.jpg

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本文引用的文献

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