| Objective:To investigate the characteristics and risk factors of coronary artery calcification and abdominal aorta calcification in patients with chronic kidney disease(CKD)in our center.Methods:1.According to the inclusion and exclusion criteria,100 patients with CKD in our hospital from December 2018 to January 2020 were selected.Their clinical data were collected,and the coronary artery calcification score(CACS)was measured by multi-slice spiral CT,According to the CACS score,the patients were divided into severe calcification group(CACS≥400)and non severe calcification group(CACS<400).The correlation and difference of clinical indicators between the two groups were compared,and the risk factors were analyzed by logistic regression.2.120 patients with chronic kidney disease in our hospital during the same period were selected,and their clinical data were collected.The abdominal aortic calcification score(AACS)was measured by lateral abdominal radio graph.The specific segments of abdominal aortic calcification were described and analyzed,and the differences of AACS in different stages of CKD were compared,According to the research of CORD(calibration outcome in renal disease),AACS<5 was no severe calcification group,AACS≥5 was severe calcification group.The correlation and difference of clinical indicators between the two groups were compared,and the risk factors were analyzed by logistic regression.Results:1.In the enrolled patients,the prevalence of coronary artery calcification was 66%,the proportion of severe calcification was 25%,the proportion of non severe calcification was 75%,the proportion of calcification in left main coronary artery,left anterior descending coronary artery,left circumflex coronary artery and right coronary artery were 8%,57%,41%,51%.15%in single vessel calcification,18%in two vessel calcification,30%in three vessel calcification,and 3%in four vessel calcification.Kruskal-Wallis test showed that there was no significant difference in CACS among different stages of CKD(P>0.05).CACS was related to age(r=0.345),dialysis vintage(r=0.243),diabetes history(r=0.422),number of involved vessels(r=0.899),VP-TR(Velocity Peak Tricuspid Regulation r=0.312),PPG(Pulmonary pressure gradient r=0.305)and PAPS(Pulmonary artery pressure).There were significant differences in age(t=-2.85,P=0.006),dialysis vintage(z=-2.11,P=0.034),diabetes history(x~2=15.81,P<0.001),TC(t=2.569,P=0.012),HDL(High density lipoprotein z=-3.409,P=0.002)and LDL(Low density lipoprotein t=2.405,P=0.018)between the two groups(P<0.05).Logistic regression showed that age(or=1.075,P=0.019)and diabetes history(or=11.954,P<0.001)were risk factors for severe coronary artery calcification.HDL(or=0.065,P=0.014)was a protective factor for severe coronary calcification.2.In the enrolled patients,the prevalence of abdominal aortic calcification was 49.2%,the proportion of severe calcification was 27.5%,the proportion of non severe calcification was 72.5%,and the proportion of abdominal aortic calcification corresponding to lumbar 1-4 segments was 20.8%,25%respectively,8%,40%.single segment calcification accounted for10%,double segment calcification accounted for 17.5%,three segment calcification accounted for 10.8%,four segment calcification accounted for 10.8%.K-W test showed that there was no significant difference in AACS score of CKD stage(P>0.05).AACS was positively correlated with age(r=0.345),diabetes(r=0.345),number of involved segments(r=0.345),LA(left arterial diameter r=0.215),MPA(main Pulmonary artery diameter r=0.239),IVS(Inter ventricular septum r=0.189),VP-TR(r=0.317),PPG(r=0.299),PAPS(r=0.291)(P<0.05).There were significant differences in age(z=-2.411,P=0.016),diabetes history(x~2=9.796,P=0.002),Ca(z=-2.255,P=0.024),LA(t=-2.188,P=0.031),MPA(z=-2.264,P=0.024)and IVS(z=-2.614,P=0.009)between the two groups(P<0.05).Logistic regression showed that age(or=1.043,P=0.04),diabetes history(or=3.968,P=0.005),serum calcium(or=19.617,P=0.033)and IVS(or=1.252,P=0.032)were risk factors for severe abdominal aortic calcification.Conclusion:1.The prevalence of coronary artery calcification in CKD patients is high,left anterior descending artery and right coronary artery are more prone to calcification,CACS is positively correlated with age,dialysis age,diabetes history,number of involved vessels,VP-TR,PPG and PAPS;diabetes history is a risk factor for severe coronary artery calcification,and normal level of HDL is a protective factor for severe coronary artery calcification.2.The prevalence of abdominal aorta calcification is high in CKD patients,which develops from distal to proximal.AACS is positively correlated with age,diabetes history,number of involved segments,LA,MPA,IVS,PPG,PAPS and VP-TR.age,diabetes history,blood calcium and IVS are risk factors for severe abdominal aorta calcification. |
