血液透析患者血清β2微球蛋白水平与死亡率的相关分析
The correlation of serum level of β2 microglobulin with mortality rate in maintenance hemodialysis patients
冯志红 1李璐 1吴丽华 1田娜1
作者信息
- 1. 宁夏医科大学总医院肾脏内科,宁夏 银川 750004;宁夏肾脏病临床研究中心,宁夏 银川 750004
- 折叠
摘要
目的 探讨维持性血液透析(MHD)患者血清β2 微球蛋白(β2-MG)与全因死亡及心脑血管死亡的相关性.方法 纳入120 例进行MHD的患者,收集患者透析前临床资料和生化检验结果,根据血清β2-MG水平三分位数将患者分为低β2-MG水平组(血清β2-MG<30.0 mg/L,n =40),中等β2-MG水平组(30.0 mg/L<β2-MG<38.8 mg/L,n =40),高β2-MG水平组(血清β2-MG≥38.8 mg/L,n =40).比较 3 组患者的基线资料,采用Kaplan-Meier法进行生存分析,Cox风险回归模型用于分析死亡率的影响因素.结果 3 组间体重、BMI、糖尿病史、残余尿量、透析龄、血磷、eGFR比较,差异均有统计学意义(P<0.05).多元逐步线性回归分析显示,MHD患者血清多因素β2-MG与残余尿量呈独立负相关(r =-3.475,P<0.05).Cox回归分析结果显示,在校正年龄、性别、血清白蛋白、肌酐、eGFR、体重和超滤量等因素后,高水平β2-MG是MHD患者发生死亡(HR =1.039,95%CI:1.003～1.076,P<0.05)与心脑血管疾病死亡的独立危险因素(HR =1.058,95%CI:1.015～1.102,P<0.05).Kaplan-Meier生存分析显示,与β2-MG中水平组比较,β2-MG高水平组患者生存率明显降低(HR = 0.330,95%CI:0.126～0.861,P<0.05).结论 血清β2-MG是MHD患者死亡的独立预测因素,提示控制血清β2-MG水平可能改善MHD患者的预后.
Abstract
Objective To explore the correlations of serum β2-MG with all-cause mortality and cardiovascular and cerebro-vascular mortality of maintenance hemodialysis(MHD)patients.Methods 120 MHD patients were selected and the clinical data and biochemical results were collected before dialysis.The MHD patients were divided into three groups according to the predialysis serum β2-MG level,which were the low β2-MG group(β2-MG≤30 mg/L,n = 40),the medium β2-MG group(β2-MG 30～38.8 mg/L,n =40)andthehighβ2-MGgroup(β2-MG≥38.8 mg/L,n =40).The baseline data of the three groups were com-pared,Kaplan-meier survival analysis and Cox risk regression model were used to analyze the possible factors influencing the mortality in MHD patients.Results There were significant differences in dry weight,BMI,prevalence of diabetes,residual urine volume,dialysis age,phosphorus and eGFR among the three groups(P<0.05).Multipe stepwise linear regression analysis showed that serum β2-MG in patients with MHD was independenily negatively correlated with residual urine vdume(r =-3.475,P<0.05).Adjustedfor multivari-ate,Cox regression analysis showed that high levels of β2-MG were independent risk factors for mortality(HR = 1.039,95%CI:1.003～1.076,P<0.05)and cardiovascular and cerebrovascular mortality(HR =1.058,95%CI:1.015～1.102,P<0.05)in MHD patients.Compared with the middle-level β2-MG group,the survival rate of patients in the high-level β2-MG group was significant-ly reduced(HR =0.330,95%CI:0.126～0.861,P<0.05).Conclusion The serum β2-MG level is a significant predictor of mor-tality in MHD patients,suggesting that controlling serum β2-MG levels may improve outcomes.
关键词
血液透析/β2-微球蛋白/全因死亡/心脑血管死亡Key words
Hemodialysis/β2-Microglobulin/All-cause death/Cardiovascular and cerebrovascular death引用本文复制引用
基金项目
宁夏回族自治区自然科学基金(2022AAC03551)
出版年
2024
NETL
NSTL
万方数据