摘要
目的:探讨血清可溶性CD40配体(sCD40L)、腱糖蛋白C(TN-C)、甲壳质酶蛋白-40(YKL-40)联合检测对维持性血液透析(MHD)并发心血管事件的预测价值.方法:选择170例MHD患者为研究对象,依据不良心血管事件(MACE)发生情况分两组,即MACE组(n=63)和非MACE组(n=107),另选同期健康体检者为对照组(n=152).比较各组血清sCD40L、TN-C、YKL-40水平,分析以上指标与MHD发生MACE的相关性及MHD并发MACE的危险因素,绘制受试者工作曲线(ROC)分析其预测价值.结果:MHD组血清sCD40L、TN-C、YKL-40水平高于对照组(均P＜0.05).MACE组的年龄、透析龄及血清sCD40L、TN-C、YKL-40水平高于非MACE组(均P＜0.05).MHD并发MACE与年龄、透析龄及血清sCD40L、TN-C、YKL-40水平呈正相关(均P＜0.05).多因素Logistic回归分析显示,MHD并发MACE的独立危险因素包括高水平sCD40L、TN-C、YKL-40以及高年龄和透析龄(均P＜0.05).血清sCD40L、TN-C、YKL-40单独及联合预测MHD并发MACE的AUC分别为0.701、0.679、0.754、0.875,联合预测价值最高,其次为YKL-40、sCD40L、TN-C(均P＜0.05).结论:MHD并发MACE患者血清sCD40L、TN-C、YKL-40水平有升高趋势,三者均为MACE发生独立危险因素,联合检测对MHD发生MACE有一定的预测价值.
Abstract
Objective:To investigate the predictive value of serum sCD40L,TN-C and YKL-40 combined detec-tion on cardiovascular events during maintenance hemodialysis.Methods:A total of 170 MHD patients were selected and divided into two groups according to the occurrence of adverse cardiovascular events(MACE),namely,MACE group(n=63)and non-MACE group(n=107),and healthy subjects in the same period were selected as control group(n=152).Serum levels of sCD40L,TN-C and YKL-40 in all groups were compared,the correlation between the above indexes and MACE in MHD and the risk factors of MHD complicated MACE were analyzed,and the pre-dictive value was analyzed by receiver operating curve(ROC).Results:Serum levels of sCD40L,TN-C and YKL-40 in MHD group were higher than those in control group(all P＜0.05).The age,dialysis age and serum levels of sCD40L,TN-C and YKL-40 in MACE group were higher than those in non-MACE group(all P＜0.05).The incidence of MACE in MHD patients was positively correlated with age,dialysis age and serum levels of sCD40L,TN-C and YKL-40(all P＜0.05).Multivariate Logistic regression analysis showed that the independent risk factors for MACE in MHD patients includ-ed high levels of sCD40L,TN-C,YKL-40,and high age and dialysis age(all P＜0.05).The AUC of serum sCD40L,TN-C and YKL-40 alone and combined to predict MHD with MACE were 0.701,0.679,0.754 and 0.875,respectively,and the combined prediction value was the highest,followed by YKL-40,sCD40L and TN-C(all P＜0.05).Conclusion:The serum levels of sCD40L,TN-C and YKL-40 in MHD patients complicated with MACE tend to increase,and the three are independ-ent risk factors for MACE development.Combined detection has certain predictive value for MACE development in MHD.
维普
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