| Objective To investigate the significance and related factors of Cardio-Ankle Vascular Index(CAVI)in peritoneal dialysis patients by examining CAVI.Study subjects and methods1.Study subjects:From December 2016 to September 2017,we selected 95 cases of chronic kidney disease(CKD)patients undergoing continuous ambulatory peritoneal dialysis in the First Affiliated Hospital of Anhui Medical University.2.Research methods:(1)Collected general information(such as name,gender,age,primary disease,dialysis age,height,weight,systolic blood pressure,diastolic blood pressure,pulse pressure,etc.),and laboratory measurements(such as hemoglobin,serum calcium,phosphorus,intact parathyroid hormone,serum albumin,uric acid,fasting blood glucose,serum total cholesterol,triglycerides,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,low density lipoprotein cholesterol,hypersensitive c-reactive protein and 25 hydroxy vitamin D levels);(2)All patients were examined by cardio-ankle vascular index(CAVI)in Cardiocardiac Function Room of our hospital in the early morning.76 cases was detected by echocardiogram,including end-diastolic ventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVED),left ventricular end systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWT).and left ventricular ejection fraction(LVEF),then the left ventricular mass fraction(LVMI)was calculated according to the formula;(3)The patients were divided into high CAVI group(CAVI?9)and normal CAVI group(CAVI<9),and the general data and laboratory measurements were compared.(4)Single factor analysis of variance was used to analyze differences of CAVI between different age groups and dialysis age groups.(5)Compared the cardiac function parameters and the incidence of left ventricular hypertrophy in two groups.(6)Spearman correlation analysis was used to analyze the correlation between CAVI and other parameters.Multivariate linear regression analysis was used to analyze independent risk factors of CAVI;(7)The subject was divided into left ventricular hypertrophy group(LVMI ? 115(male)/ 95(female)g / m2 and non-left ventricular hypertrophy group(LVMI< 115(male)/ 95(female)g / m2),CAVI and indicators were compared.Spearman correlation analysis was used to analyze the correlation between LVMI and other parameters.Multivariate linear regression analysis was used to analyze independent risk factors of LVMI;(8)Statistical processing: using SPSS 22.0 statistical software,P<0.05 was statistically significant.3.Results:(1)The abnormal rate of CAVI in peritoneal dialysis patients was as high as 32.67%,CAVI of high CAVI group(9.85±0.73)was significantly higher than that of normal CAVI group(7.67±0.81),the age(54.64±5.68),dialysis age(48.32±30.43),pulse pressure(57.41±12.43),serum correctional calcium(2.52±0.28),phosphorus(2.22±0.66),the calcium-phosphorus product(5.59±1.70),fasting blood glucose(6.02±1.83)of high CAVI group was significantly higher than that of normal CAVI group,and hemoglobin,serum albumin of high CAVI group was significantly lower than that of normal CAVI group.(2)CAVI of elder group was significantly higher than that of youth group(7.43±1.11)and middle-aged group(8.4±1.16),and the p value <0.05.CAVI of dialysis patients among three to six years(8.62±1.14)and over six years(8.62±1.14)were significantly higher than that of less than 3 years(8.00±1.37),p values <0.05,the difference was statistically significant.(3)The relationship between CAVI and left ventricular hypertrophy in peritoneal dialysis patients:The IVST,LVED,LVESD and LVPWT of high CAVI group were higher than that of normal CAVI group.LVEF of high CAVI group was significantly lower than that of normal CAVI group,and the incidence of left ventricular hypertrophy of high CAVI group was significantly higher than that of normal CAVI group.(4)The risk factors of CAVI:Spearman correlation analysis showed that CAVI was positively correlated with age,dialysis age,pulse pressure,serum correctional calcium,phosphorus,the calcium-phosphorus product,fasting blood glucose,hs-CRP(r val ues were 0.520?0.260?0.244?0.347?0.231?0.338?0.225?0.298 respectively),and negatively with serum albumin,25 hydroxyvitamin D(r values were-0.335?-0.222).Multivariate linear regression analysis showed that age and serum albumin level were independent risk factors for CAVI.(5)The risk factors of LVH(left ventricular hypertrophy):The CAVI(8.60±1.89),phosphorus(2.17±0.62)and calcium-phosphorus product(5.38±1.65)of left ventricular hypertrophy group were significantly higher than that of non-left ventricular hypertrophy group,and hemoglobin(85.23±19.16),albumin(33.23±5.17)of left ventricular hypertrophy group were significantly lower than that of non-left ventri cular hypertrophy group.Spearman correlation analysis showed that LVMI was positively correlated with CAVI,pulse pressure,serum phosphorus and the calcium-phosphorus product(r values were: 0.391,0.244,0.199,0.371,0.419),and negatively correlated with hemoglobin,blood albumin(r values were:-0.427,-0.303),p < 0.05,the CAVI and hemoglobin were independent risk factors for LVH.4.Conclusion:(1)CAVI was positively correlated with age,dialysis age,pulse pressure,serum correctional calcium,serum phosphorus,the calcium-phosphorus product,fasting blood glucose,hs-CRP,and negatively correlated with serum albumin,25 hydroxyvitamin D.Age,serum albumin were independent risk factors for CAVI.CAVI in dialysis patients over three years was significantly higher than that less three years.CAVI was recommended for routine testing by dialysis patients over three years.(2)The abnormal rate of CAVI in peritoneal dialysis patients was as high as 32.67%.CAVI was simple,noninvasive and reliable,and can be used as a good indicator for evaluating atherosclerosis in peritoneal dialysis patients.CAVI is an independent risk factor of left ventricular hypertrophy,which has a certain predictive value for left ventricular hypertrophy,which can provide a basis for intervention al therapy for clinicians... |
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