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泰国血液透析患者动脉僵硬的流行情况及相关因素:一项多中心横断面研究。

Prevalence of arterial stiffness and associated factors in Thai hemodialysis patients: A multicenter cross-sectional study.

出版信息

Clin Nephrol. 2024 May;101(5):222-231. doi: 10.5414/CN111187.

Abstract

BACKGROUND

Hemodialysis (HD) patients have higher risks of cardiovascular morbidity and mortality compared to the general population. Cardio-femoral pulse wave velocity (cfPWV) is associated with cardiovascular morbidity and mortality in HD patients. This study aimed to evaluate the prevalence and associated factors of arterial stiffness in Thai HD patients.

MATERIALS AND METHODS

This cross-sectional multicenter study was conducted at 4 HD centers in Bangkok, Thailand. cfPWV and peripheral blood pressure were assessed using SphygmoCor XCEL Model EM4C (AtCor medical Inc., Sydney, Australia). Significant arterial stiffness was defined by cfPWV > 10 m/s. Univariate and multivariable regression models were used to identify factors associated with arterial stiffness.

RESULTS

144 HD patients were assessed for arterial stiffness by cfPWV measurement. The mean age of the patients was 57.8 ± 12.8 years, with 50% male and a mean dialysis vintage of 7.6 years. The mean cfPWV was 11.7 ± 3.0 m/s. The prevalence of increased arterial stiffness was 73.6%. Multivariable analysis showed that older age, hypertension, lower HD adequacy, and higher fasting plasma glucose were independently associated with arterial stiffness.

CONCLUSION

There was a high prevalence of arterial stiffness among HD patients. Some modifiable factors found to be independently associated, including dialysis adequacy and glycemic control, should be further investigated to identify approaches to retard vascular stiffness.

摘要

背景

与普通人群相比,血液透析(HD)患者有更高的心血管发病率和死亡率风险。心-股脉搏波速度(cfPWV)与 HD 患者的心血管发病率和死亡率相关。本研究旨在评估泰国 HD 患者动脉僵硬度的流行情况及其相关因素。

材料与方法

这是一项在泰国曼谷的 4 个 HD 中心进行的横断面多中心研究。使用 SphygmoCor XCEL Model EM4C(AtCor medical Inc.,悉尼,澳大利亚)评估 cfPWV 和外周血压。cfPWV>10m/s 定义为显著动脉僵硬度。采用单变量和多变量回归模型来确定与动脉僵硬度相关的因素。

结果

通过 cfPWV 测量评估了 144 例 HD 患者的动脉僵硬度。患者的平均年龄为 57.8±12.8 岁,男性占 50%,透析龄平均为 7.6 年。平均 cfPWV 为 11.7±3.0m/s。动脉僵硬度增加的患病率为 73.6%。多变量分析显示,年龄较大、高血压、较低的 HD 充分性和较高的空腹血糖与动脉僵硬度独立相关。

结论

HD 患者中存在很高的动脉僵硬度患病率。一些可改变的因素被发现与动脉僵硬度独立相关,包括透析充分性和血糖控制,应进一步研究以确定延缓血管僵硬度的方法。

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