目的: 探讨慢性肾脏病（chronic kidney disease,CKD）非透析患者高敏肌钙蛋白I（hypersensitive troponin I,hs-cTn I）水平的相关影响因素,为早期筛选、识别慢性肾脏病患者中的心血管事件危险人群提供帮助。方法: 单中心回顾性分析解放军某医院2018年01月—2019 年01月期间住院诊断为CKD的非透析患者256例,将患者以hs-cTnI浓度0.034 ng/mL为界限分为hs-cTnI正常组（n=183）和hs-cTnI升高组（n=73）,比较两组患者一般资料及实验室指标[血肌酐（Scr）、心肌酶、血尿素氮（BUN）、同型半胱氨酸、β2微球蛋白、高敏C反应蛋白、甲状旁腺素（PTH）、hs-cTn I],每位患者都进行心脏彩超检查,分析患者的hs-cTn I相关影响因素。结果: 两组患者冠心病病史、收缩压、 肾小球滤过率（eGRF）、Scr、BUN、β2微球蛋白、PTH、血磷（P）、血红蛋白（Hb）、左心室质量指数（LVMI）、N-末端脑钠肽前体（NT- proBNP）比较差异具有统计学意义;多元线性逐步回归分析结果显示冠心病病史、Hb、NT-proBNP、LVMI、P 及PTH为hs-cTn I的影响因素,CKD 非透析患者的冠心病病史,Hb降低,P、PTH、NT-pro BNP和LVMI的升高可引起 hs-cTn I水平升高。结论: 非透析CKD患者的冠心病病史、贫血、NT-proBNP 升高、左室肥大、甲状旁腺亢进及高磷血症会引起hs-cTn I升高。
Abstract
Objective To explore the related influencing factors of hs-cTnI level in non-dialysis patients with chronic kidney disease, and to provide help for early screening and identifiCation of Cardiovascular event risk groups in patients with chronic kidney disease. Methods A single-center retrospective analysis was performed on 256 non-dialysis patients diagnosed with CKD who were hospitalized in a certain hospital of the People's Liberation Army from January 2018 to January 2019. Patients were divided into normal hs-cTnI group (n=183) and elevated hs-cTnI group (n=73) with hs-cTnI concentration of 0.034 ng/mL. General data and laboratory indicators (serum creatinine, myocardial enzyme, blood urea nitrogen, homocysteine, β2 microglobulin, hypersensitive C-reactive protein, parathyroid hormone, hs-cTnI) were compared between the two groups. Color Doppler ultrasound was performed for each patient, and relevant statistical methods were used to analyze the affecting factors of hs-cTnI in the patients. Results There were statistically significant differences in coronary heart disease history, systolic blood pressure, eGRF, Scr, BUN, β2 microglobulin, PTH, P, hemoglobin (Hb), left ventricular mass index (LVMI) and N terminal-pro brain natriuretic peptide (NT-proBNP) between the two groups. The results of multiple linear stepwise regression analysis showed that coronary heart disease history, Hb, NT-proBNP, LVMI, P and PTH were the influencing factors of hs-cTnI. The coronary heart disease history of non-dialysis patients with CKD showed a decrease in Hb. The increase of P, PTH, NT-pro BNP and LVMI Can lead to the increase of hs-cTn I level. Conclusion A history of coronary heart disease, anemia, elevated NT-proBNP, left ventricular hypertrophy, hyperparathyroidism, and hyperphosphatemia in non-dialysis CKD patients can cause hypersensitive troponin I to increase.
关键词
慢性肾脏病 /
高敏肌钙蛋白I /
心血管风险
Key words
chronic kidney disease /
hypersensitive troponin I /
cardiovascular event
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