天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (3): 274-278.doi: 10.11958/20252525

• 临床研究 • 上一篇    下一篇

尿酸、脂联素与水肿指数对腹膜透析患者主要不良心血管事件的预测价值

刘俊芬1(), 郭宝珠1, 程志华2, 卫志锋1, 刘圣君1   

  1. 1 河北北方学院附属第一医院肾内科（邮编075000）
    2 超声医学科
  • 收稿日期:2025-07-17 修回日期:2025-11-19 出版日期:2026-03-15 发布日期:2026-03-17
  • 作者简介:刘俊芬（1987），女，主治医师，主要从事原发性、继发性肾小球疾病、终末期肾脏病方面研究。E-mail：Lanzhouliujunfen@163.com
  • 基金资助:
    河北省医学科学研究项目(20220619)

The predictive value of uric acid, adiponectin and edema index for major adverse cardiovascular events in peritoneal dialysis patients

LIU Junfen1(), GUO Baozhu1, CHENG Zhihua2, WEI Zhifeng1, LIU Shengjun1   

  1. 1 Department of Nephrology
    2 Department of Ultrasound Medicine, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2025-07-17 Revised:2025-11-19 Published:2026-03-15 Online:2026-03-17

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摘要：

目的 探讨尿酸（UA）和脂联素（APN）与水肿指数对腹膜透析（PD）患者主要不良心血管事件（MACE）的预测价值。方法 纳入80例行PD治疗的患者为研究组，另选取同期健康体检者30例为对照组，比较2组血清UA、APN水平及水肿指数。另根据随访中PD患者是否发生MACE将其分为MACE组22例和非MACE组58例，分析血清UA、APN及水肿指数与其发生MACE的关系，受试者工作特征（ROC）曲线评估血清UA、APN及水肿指数对PD患者发生MACE的预测价值。结果 研究组血清UA、APN水平及水肿指数均高于对照组（均P<0.01）。血清UA、APN水平与PD患者水肿指数呈正相关（r分别为0.456、0.341，P<0.01）。MACE组血清UA水平、水肿指数高于非MACE组，血清APN水平低于非MACE组（均P<0.01）。血清UA水平、水肿指数与PD患者发生MACE呈正相关（rs分别为0.438、0.465，P<0.001）；血清APN水平与PD患者发生MACE呈负相关（rs=-0.447，P<0.001）。血清UA、APN及水肿指数预测PD患者发生MACE的曲线下面积（AUC）分别为0.709（95%CI：0.586~0.833）、0.771（95%CI：0.649~0.892）、0.722（95%CI：0.596~0.848），三项联合预测的AUC为0.944（95%CI：0.890~0.998）。结论 PD患者血清UA、APN水平及水肿指数升高，三者均与MACE发生相关，联合检测对MACE的预测效能更高。

关键词: 腹膜透析，持续不卧床, 尿酸, 脂联素, 水肿指数, 主要不良心血管事件

Abstract:

Objective To explore the predictive value of uric acid (UA), adiponectin (APN) and edema index for major adverse cardiovascular events (MACE) in peritoneal dialysis (PD) patients. Methods Eighty patients who underwent PD treatment were selected as the study group, and another 30 healthy individuals who underwent physical examination during the same period were selected as the control group. The serum levels of UA, APN and the edema index were compared between the two groups. Patients were divided into the MACE group (n=22) and the non-MACE group (n=58) based on whether MACE occurred, and the relationship between serum UA, APN and edema index and the occurrence of MACE in PD patients was analyzed. ROC curve was established to evaluate the predictive value of serum UA, APN and edema index for the occurrence of MACE in PD patients. Results The serum levels of UA, APN and the edema index were all higher in the study group than those in the control group (all P<0.01). The serum levels of UA and APN were both positively correlated with the edema index of PD patients (r=0.456, 0.341, P<0.01). The serum UA level and edema index were significantly higher in the MACE group than those in the non-MACE group, and the serum APN level was significantly lower than that in the non-MACE group (all P<0.01). The serum UA level and edema index were positively correlated with the occurrence of MACE in PD patients (rs=0.438, 0.465, P<0.001). The serum level of APN was negatively correlated with the occurrence of MACE in PD patients (rs=-0.447, P<0.001). The area under the curve (AUC) of serum UA, APN and edema index in predicting MACE in PD patients were 0.709 (95%CI: 0.586-0.833), 0.771 (95%CI: 0.649-0.892) and 0.722 (95%CI: 0.596-0.848), respectively. The AUC of the combined prediction of the three was 0.944 (95%CI: 0.890-0.998). Conclusion The serum levels of UA, APN and edema index are increased in PD patients. All the three are related to the occurrence of MACE. The combined detection has a higher predictive efficacy for MACE.

Key words: peritoneal dialysis, continuous ambulatory, uric acid, adiponectin, edema index, major adverse cardiovascular events

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