血浆纤维蛋白原：腹膜透析患者左心室重构的驱动因素及其相关危险因素。

Plasma fibrinogen: a driver of left ventricular remodeling in patients undergoing peritoneal dialysis and its related risk factors.

机构信息

Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Ren Fail. 2023;45(2):2255679. doi: 10.1080/0886022X.2023.2255679. Epub 2023 Sep 19.

DOI:10.1080/0886022X.2023.2255679

PMID:38346031

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10512895/

Abstract

BACKGROUND AND AIM

Plasma fibrinogen has been proven to be significantly associated with cardiovascular mortality in patients undergoing peritoneal dialysis (PD). The study aimed to investigate the role of fibrinogen in left ventricular (LV) remodeling and functions in patients on PD, and explore risk factors related to high fibrinogen level.

METHODS

From February 2008 to July 2018, adult patients on regular PD for at least 1 month were recruited and followed up for two years. Correlation analysis was performed to explore the fibrinogen level and echocardiography measurements. Pathogenic factors correlated to the left ventricular hypertrophy (LVH) progression were explored by logistic regression models and the role of fibrinogen in it was verified by receiver operating characteristic (ROC) curves. Linear regression models were conducted to identify factors associated with fibrinogen level.

RESULTS

A total of 278 patients undergoing PD (168 males, 60.4%) were recruited. Patients were trisected according to fibrinogen levels at baseline. Mean wall thickness (MWT), relative wall thickness (RWT), and left ventricular mass index (LVMI) were positively associated with fibrinogen level while / ratio was negatively associated with it. Multivariate logistic regression and ROC curve showed that fibrinogen was an independent risk factor for LVH progression. Multivariate linear regression analysis identified age, total cholesterol (CHO), fasting blood glucose (FBG), and high-sensitivity C-reactive protein (hsCRP) were significantly related to plasma fibrinogen level.

CONCLUSIONS

An elevated fibrinogen level was independently associated with LVH progression in patients undergoing PD. Older age, higher level of FBG, CHO, and hsCRP were risk factors for elevated plasma fibrinogen level.

摘要

背景与目的

已有研究证明，血浆纤维蛋白原与腹膜透析（peritoneal dialysis，PD）患者的心血管死亡率显著相关。本研究旨在探讨纤维蛋白原在 PD 患者左心室（left ventricular，LV）重构和功能中的作用，并探讨与高纤维蛋白原水平相关的危险因素。

方法

2008 年 2 月至 2018 年 7 月，连续招募了至少接受 1 个月规律 PD 治疗的成年患者，并对其进行了为期 2 年的随访。采用相关性分析探讨纤维蛋白原水平与超声心动图测量值的关系。通过 logistic 回归模型探讨与 LVH 进展相关的致病因素，并通过受试者工作特征（receiver operating characteristic，ROC）曲线验证纤维蛋白原在其中的作用。采用线性回归模型确定与纤维蛋白原水平相关的因素。

结果

共纳入 278 例 PD 患者（男 168 例，占 60.4%）。根据基线纤维蛋白原水平将患者三分位。平均壁厚度（mean wall thickness，MWT）、相对壁厚度（relative wall thickness，RWT）和左心室质量指数（left ventricular mass index，LVMI）与纤维蛋白原水平呈正相关，而 / 比值与纤维蛋白原水平呈负相关。多变量 logistic 回归和 ROC 曲线显示，纤维蛋白原是 LVH 进展的独立危险因素。多元线性回归分析确定年龄、总胆固醇（total cholesterol，CHO）、空腹血糖（fasting blood glucose，FBG）和高敏 C 反应蛋白（high-sensitivity C-reactive protein，hsCRP）与血浆纤维蛋白原水平显著相关。