| 汪春芳,林 丽,张丽娟,司静静,徐 骏.老年营养风险指数联合血清铁蛋白水平对维持性血液透析患者腹主动脉钙化风险的预测价值[J].,2023,(4):744-748 |
| 老年营养风险指数联合血清铁蛋白水平对维持性血液透析患者腹主动脉钙化风险的预测价值 |
| Predictive Value of Geriatric Nutritional Risk Index Combined with Serum Ferritin Level on the Risk of Abdominal Aortic Calcification in Maintenance Hemodialysis Patients |
| 投稿时间：2022-07-18 修订日期：2022-08-14 |
| DOI：10.13241/j.cnki.pmb.2023.04.028 |
| 中文关键词: 维持性血液透析 老年营养风险指数 铁蛋白 腹主动脉钙化 预测价值 |
| 英文关键词: Maintenance hemodialysis Geriatric nutritional risk index Ferritin Abdominal aortic calcification Predictive value |
| 基金项目:安徽省自然科学基金项目（1908085MH245） |
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| 中文摘要: |
| 摘要 目的：探讨老年营养风险指数（GNRI）联合血清铁蛋白（SF）水平对维持性血液透析患者腹主动脉钙化（AAC）风险的预测价值。方法：选取2020年3月-2022年4月安徽省铜陵市人民医院收治的112例维持性血液透析患者，根据有无合并AAC分为钙化组（n=63）与未钙化组（n=49），比较两组临床资料、GNRI、血清SF水平。根据AAC评分将钙化组分为轻度钙化组（n=24）、中度钙化组（n=21）与重度钙化组（n=18），比较三组GNRI、血清SF水平。采用Pearson相关性分析法分析钙化患者GNRI、血清SF水平与AAC评分的相关性；采用多因素Logistic回归模型分析AAC发生的影响因素，采用受试者工作特征（ROC）曲线分析GNRI、血清SF对维持性血透患者发生AAC风险的预测价值。结果：钙化组年龄大于未钙化组，白蛋白水平及GNRI低于未钙化组，透析时间长于未钙化组，低密度脂蛋白胆固醇、血磷、全段甲状旁腺素（iPTH）、血清SF水平高于未钙化组（P＜0.05）。轻、中、重度钙化组GNRI依次下降，血清SF水平依次上升（P＜0.05）。Pearson相关性显示，GNRI与AAC评分呈负相关，SF水平与其呈正相关（P＜0.05）。多因素Logistic结果显示，透析时间增加、血磷、iPTH、血清SF水平上升，白蛋白水平下降与GNRI分值降低为AAC发生的危险因素（P＜0.05）。ROC曲线显示，GNRI对AAC预测的曲线下面积（AUC）为0.744，血清SF的AUC为0.769，两者联合检测的AUC为0.844，GNRI的灵敏度与特异度为58.72%、77.66%，SF的灵敏度与特异度为85.75%、73.51%，两者联合检测的灵敏度与特异度为84.10%、79.67%。结论：GNRI下降及血清SF水平上升为维持性血透患者发生AAC的危险因素，与钙化程度密切相关，两者联合检测作为预测患者发生AAC风险的有效指标具有更高价值。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the predictive value of geriatric nutritional risk index (GNRI) combined with serum ferritin (SF) level on the risk of abdominal aortic calcification (AAC) in maintenance hemodialysis patients. Methods: 112 maintenance hemodialysis patients who were treated in our hospital from March 2020 to April 2022 were selected, and they were divided into calcification group (n=63) and non calcification group (n=49) according to the presence or absence of AAC. The clinical data, GNRI and serum SF level were compared between the two groups. According to the AAC score, the calcification group was divided into mild calcification group (n=24), moderate calcification group (n=21) and severe calcification group (n=18), the GNRI and serum SF level of the three groups were compared. Pearson correlation was used to analyze the correlation between GNRI, SF level and it in calcified patients. Multivariate Logistic regression model was used to analyze the influencing factors of AAC, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of GNRI and serum SF on the risk of AAC in maintenance hemodialysis patients. Results: The age of calcification group was older than that of non calcification group, the level of albumin and GNRI were lower than that of non calcification group, the dialysis time was longer than that of non calcification group, and the low density lipoprotein cholesterol, blood phosphorus, whole parathyroid hormone (iPTH) and serum SF levels were higher than those of non calcification group (P＜0.05). In mild, moderate and severe calcification groups, GNRI decreased in turn, and serum SF level increased in turn (P＜0.05). Pearson correlation analysis showed that GNRI was negatively correlated with AAC score, and serum SF level was positively correlated with AAC score (P＜0.05). Multivariate Logistic analysis showed that the increase of dialysis time, the increase of serum phosphorus, iPTH, serum SF level, the decrease of albumin level and the decrease of GNRI score were the risk factors for the occurrence of AAC (P＜0.05). The ROC curve showed that the area under the curve (AUC) predicted by GNRI to AAC was 0.744, the AUC of serum SF was 0.769, the AUC of combined detection was 0.844, the sensitivity and specificity of GNRI were 58.72% and 77.66%, the sensitivity and specificity of SF were 85.75% and 73.51%, and the sensitivity and specificity of combined detection were 84.10% and 79.67%. Conclusion: The decrease of GNRI and the increase of serum SF level are the risk factors of AAC in maintenance hemodialysis patients, which are closely related to the degree of calcification. The combined detection of GNRI and SF has higher value as an effective index to predict the risk of AAC. |
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