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題名 | Peripheral Arterial Disease and Its Correlates in Chronic Hemodialysis Patients=長期血液透析病人之周邊動脈疾病及其相關因子 |
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作者 | 蔡丞凱; 楊正銘; 林勤堯; 張宗興; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷期 | 22:2 2008.06[民97.06] |
頁次 | 頁117-123+140 |
分類號 | 415.38 |
關鍵詞 | 周邊動脈疾病; 動脈硬化; 血液透析; 慢性腎臟病; 末期腎臟疾病; Peripheral arterial disease; Atherosclerosis; Hemodialysis; Chronic kidney disease; End-stage renal disease; |
語文 | 英文(English) |
中文摘要 | 背景:周邊動脈疾病是來自於全身性動脈硬化所導致相當常見的情形,而且在末期腎病的病人經常會導致明顯的發病甚至死亡。由於過去僅有少數文獻報告,所以對於臨床上周邊動脈疾病和末期肝臟病之間的關係值得更深入的探討。方法:吾人收集來自於單一醫學中心接受規則血液透析超過三個月的246位病人,利用踝肱動脈血壓指數(ABI)來篩檢周邊動脈疾病。踝肱動脈血壓指數測量值小於0.9則視為異常。另外我們也檢查了其他許多臨床以及生化的指標,以研究其與周邊動脈疾病之相關性。結果:周邊動脈疾病在本研究之病人中其盛行率為24%。和ABI呈正相關的有血清白蛋白(r=0.252, p<0.001),血清肌酸酐(r=0328, P<0001),血清磷(r=0.181, p=0.005),血清全段副甲狀腺素(r=0.139, p=0.030),血清鈣磷乘積(r=0.174, p=0.006)和血清高密度膽固醇(r=0.189, p=0.003);而ABI和年齡呈負相關(r=0.223, P<0.001)。在單變項分析中,和周邊動脈疾病有顯著相關的有既存之心血管疾病,年齡,糖尿病,血清白蛋白及肌酸酐。多變項線性回歸分析則顯示周邊動脈疾病和年齡、糖尿病、血清肌酸酐和血清白蛋白有顯著相關。結論:我們發現台灣接受常規血液透析病人有相當高的周邊動脈疾病盛行率。高齡,糖尿病,血清肌酸酐以及血清白蛋白是周邊動脈疾病的獨立預測因子。 |
英文摘要 | Background: Peripheral arterial disease (PAD) is a common condition resulting from systemic atherosclerosis and often leads to substantial morbidity and mortality in patients with end stage renal disease (ESRD). Since past studies reporting on this are few, it is noteworthy to identify its prevalence and the clinical correlation between PAD and patients with maintenance hemodialysis (HD). Methods: Two hundred and forty six patients flout a single medical center received HD for more than 3 months were screened for PAD by means of the ankle-brachial index (ABI). A ratio of<0.9 was indicative of an abnormal ABI. We also examined lots of clinical and biochemical parameters to check their correlation with PAD. Results: The prevalence rate of PAD (ABI<0.9) was 243%, ABI was positively correlated with serum albumin (r=0.252, p<0.001), serum creatinine (r=0.328, p<0.001), serum phosphate (r=0.181, p=0.005), serum iPTH (r=0.139, p=0.030), serum calcium phosphate ate product (r=0.174, p=0.006), and serum HDL-cholesterol (r=0.189, p=0.003); and negatively correlated with age (r=0.223, P<0.001). In univariate analysis, PAD was found to he positively associated with pre-existing cardiovascular disease (CVD), age and diabetes mellitus, but negatively associated with serum albumin and serum creatinine. Multivariate logistic regression analysis showed that PAD was associated with age, DLVI, serum creatinine and serum albumin. Conclusion: In the present study, we found high prevalence of PAD among Taiwanese patients on chronic hemodialysis. Age, diabetes mellitus, serum creatinine and serum albumin are independent predictors of PAD. |
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