Abstract:

Objective　To explore the efficacy of serum triglyceride/high density lipoprotein cholesterol (TG/HDLC) and secreted phosphoprotein 24 (SPP24) in predicting cardiovascular events in hemodialysis patients. Methods　A total of 159 patients undergoing maintenance hemodialysis admitted to Chang An Hospital from June 2020 to June 2022 were prospectively selected, including 88 males and 71 females, aged >18 years, and cardiovascular events were followed up for 1 year. Forty-one patients with cardiovascular events were included in the cardiovascular event group, and 118 patients without cardiovascular events were included in the non-cardiovascular event group. Serum TG/HDLC and SPP24 levels were detected. t test, χ² test, and logistic regression analysis model were used to analyze the factors affecting the occurrence of cardiovascular events in maintenance hemodialysis patients. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of serum TG/HDLC and SPP24 in predicting cardiovascular events in maintenance hemodialysis patients. Results　Multivariate logistic regression analysis showed that dialysis age (OR=4.586, 95%CI 1.887-11.145), TG/HDLC (OR=3.904, 95%CI 1.594-9.563), and SPP24 level (OR=0.308, 95%CI 0.127-0.748) were the influencing factors for cardiovascular events in maintenance hemodialysis patients (all P<0.05). ROC analysis results showed that the sensitivities of TG/HDLC, SPP24, and their combination in predicting cardiovascular events in maintenance hemodialysis patients were 70.73% (95%CI 54.26%-83.35%), 68.29% (95%CI 51.78%-81.42%), and 82.93% (95%CI 67.35%-92.30%), respectively, the specificities were 70.34% (95%CI 61.12%-78.21%), 75.42% (95%CI 66.48%-82.68%), and 89.83% (95%CI 82.56%-94.40%), respectively, and the areas under the curves were 0.733 (95%CI 0.638-0.828), 0.708 (95%CI 0.597-0.819), and 0.894 (95%CI 0.829-0.959), respectively. Conclusion　Serum TG/HDLC combined with SPP24 can improve the predictive efficacy of cardiovascular events in maintenance hemodialysis patients.

Key words:

Hemodialysis, Cardiovascular events, Triglyceride/high density lipoprotein cholesterol, Secreted phosphoprotein 24, Efficiency

摘要：

目的　分析血清三酰甘油/高密度脂蛋白胆固醇（TG/HDLC）、分泌型磷蛋白24（SPP24）对血液透析患者心血管事件发生的预测效能。方法　前瞻性选取2020年6月至2022年6月长安医院收治的159例行维持性血液透析患者，其中男88例，女71例，年龄>18岁，随访患者1年期间心血管事件发生情况，将出现心血管事件的41例患者纳入心血管事件组，未出现心血管事件的118例患者纳入非心血管事件组。检测患者血清TG/HDLC、SPP24水平。采用t检验、χ²检验、logistic回归分析模型分析影响维持性血液透析患者心血管事件发生的因素，采用受试者操作特征曲线（ROC）分析血清TG/HDLC、SPP24预测维持性血液透析患者心血管事件发生的效能。结果　多因素logistic回归分析显示，透析龄（OR=4.586，95%CI 1.887～11.145）、TG/HDLC（OR=3.904，95%CI 1.594～9.563）、SPP24水平（OR=0.308，95%CI 0.127～0.748）是影响维持性血液透析患者心血管事件发生的影响因素（均P<0.05）。ROC分析结果显示，TG/HDLC、SPP24及二者联合预测维持性血液透析患者发生心血管事件的灵敏度分别为70.73%（95%CI 54.26%～83.35%）、68.29%（95%CI 51.78%～81.42%）、82.93%（95%CI 67.35%～92.30%），特异度分别为70.34%（95%CI 61.12%～78.21%）、75.42%（95%CI 66.48%～82.68%）、89.83%（95%CI 82.56%～94.40%），曲线下面积（AUC）分别为0.733（95%CI 0.638～0.828）、0.708（95%CI 0.597～0.819）、0.894（95%CI 0.829～0.959）。结论　血清TG/HDLC联合SPP24可提高对维持性血液透析患者心血管事件发生的预测效能。

关键词:

血液透析, 心血管事件, 三酰甘油/高密度脂蛋白胆固醇, 分泌型磷蛋白24, 效能