JAHA:hs-cTnT和CRP对血液透析和PD患者预测价值分析!

2018-02-26 xing.T MedSci原创

由此可见,hs-cTnT和CRP是血液透析和PD患者预测死亡和主要心血管不良事件一个有用的工具。鉴于在PD患者中,hs-cTnT水平随着时间推移而增加,间断监测可以为风险评估带来帮助。相比之下,血液透析患者hs-cTnT区间变化较小,没有必要进行间断监测。

透析患者死亡率极高。生物标记物可能是这一人群危险分层的有用工具。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员评估了高敏肌钙蛋白T(hs-cTnT)和C反应蛋白(CRP)在稳定的血液透析和腹膜透析(PD)患者中对不良结局的预测价值,同时,也评估了hs-cTnT的变异性。

该回顾性队列研究共纳入了574例透析患者(血液透析347例,PD 227例)。研究结局包括死亡率和主要不良心血管事件,中位随访3.5年。


hs-cTnT是血液透析和PD患者一个独立的结局预测指标。当hs-cTnT超过第3个五分位数(>49ng/L)时,增加的风险变得显著。ROC曲线下面积分析表明,将hs-cTnT添加到临床参数可以显著改善PD患者死亡的预测性能(P=0.002)。只有CRP是PD患者预后的独立预测因子。只有CRP超过最高五分位数(>16.8mg/L)时,增加的风险变得显著。hs-cTnT在血液透析患者整个随访期间保持相对稳定,而对于PD患者,与基线相比,hs-cTnT在2年内增加23.63%,在年时增加29.13%(P<0.001)。

由此可见,hs-cTnT和CRP是血液透析和PD患者预测死亡和主要心血管不良事件一个有用的工具。鉴于在PD患者中,hs-cTnT水平随着时间推移而增加,间断监测可以为风险评估带来帮助。相比之下,血液透析患者hs-cTnT区间变化较小,没有必要进行间断监测。

原始出处:

Titi Chen,et al. High‐Sensitivity Troponin T and C‐Reactive Protein Have Different Prognostic Values in Hemo‐ and Peritoneal Dialysis Populations: A Cohort Study.JAHA.2018. https://doi.org/10.1161/JAHA.117.007876

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    2018-02-28 habb
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    2018-02-28 zhaohui6731
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    2018-02-28 rebeccajiejie
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    2018-02-28 zhouqu_8
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    2018-02-26 明月清辉

    谢谢分享.学习了

    0

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