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相關文獻
- Prevalence and Clinical Correlates of Peripheral Arterial Disease in Hemodialysis Patients
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題名 | Prevalence and Clinical Correlates of Peripheral Arterial Disease in Hemodialysis Patients=血液透析患者的周邊動脈疾病盛行率及相關臨床表徵 |
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作者 | 林柏松; 陳珍釵; 楊士民; 簡孝文; 郭元銓; 白美安; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷期 | 19:3 民94.09 |
頁次 | 頁113-120+149 |
分類號 | 415.816 |
關鍵詞 | 血液透析; 周邊動脈疾病; Hemodialysis; Peripheral artery disease; Risk factors; |
語文 | 英文(English) |
中文摘要 | 背景:周邊動脈疾病是動脈粥樣硬化相當常見臨床表徵、且可以嚴重影響血液透析患者的罹病率及死亡率,但是極少研究提及血液透析患者的周邊動脈疾病盛行率及相關臨床特徵。方法:在此研究我們使用腳腕上臀索引(ABI)篩選243位接受至少三個月血液透析的患者的周邊動脈疾病,當腳腕上臀比率<0.9時、表示病患患有周邊血管疾病。同時,我們也檢查病患的一些相關生化及發炎指標。結果:血液透析患者的周邊動脈疾病盛行率是27.8%。ABI與血清蛋白值(r=0.134, p=0.41)及高密度脂蛋白膽固醇值(r=0.168, p=0.012)呈正相關;卻與年齡(r=0.135, P=0.039),經自然對數換轉的C-反應蛋白值(log-transformed CRP) (r=-0.173, p=0.008),空腹血糖(r=0.263, p<0.001)及三酸甘油脂值(r=0.152, p=0.20)呈負相關。單變單變項統計分析顯示女性別,高三酸苷油脂值,心血管病史及糖尿病皆與周邊動脈疾病有關聯。至於多變數邏輯迴歸分析顯示,糖尿病、CRP值、心血管病史及透析治療的持續期間皆為PAD的獨立相關因子。結論,在這初步的研究,我們發現周邊動脈疾病的盛行率偏高,且糖尿病,CRP值,心血管病史及透析治療的持續期間皆可以獨立預測周邊動脈疾病的發生。 |
英文摘要 | Background: Peripheral arterial disease (PAD) is the most common manifestation of systemic atherosclerosis and accounts for significant morbidity and mortality among end-stage renal disease (ESRD) patients. However, few studies have identified the prevalence and clinical correlates of PAD in this specific population. Methods: Two hundred and thirty-four patients receiving stable HD > 3 months from a single center were screened for PAD using the ankle-brachial index (ABI). The ABI was measured and a ratio of < 0.9 was considered abnormal. Several biochemical and inflammatory parameters were also examined. Results: The prevalence rate of PAD (ABI<0.9) was 27.8%. ABI was positively correlated with serum albumin (r=0.134, p=0.41) and serum HDL-cholesterol (r=0.168, p=0.012) and negatively correlated with age (r=0.135, P=0.039), log-transformed CRP levels (r=-0.173, p=0.008), fasting blood sugar (r=0.263, p<0.001) and serum triglyceride (r = 0.152, p = 0.20). In univariate analysis, PAD was found to be associated with hypertriglyceridemia, CRP levels, female gender, pre-existing CVD, and diabetes mellitus. Multivariate logistic regression analysis, however, revealed that PAD was associated with diabetes mellitus, pre-existing CVD, duration on dialysis and CRP levels. Conclusion: In this preliminary study, we found that the prevalence of PAD in Taiwanese patients on HD is high. Presence of diabetes, pre-existing CVD, duration on dialysis and CRP levels independently predicts the presence of PAD. |
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