健康生活方式可降低慢性肾病患者心血管事件发生

2012-12-10 Ana C. Ricardo EGMN

  美国伊利诺伊大学的Ana C. Ricardo博士在2012年肾脏周上报告的一项初步研究结果显示,健康生活方式可降低慢性肾病(CKD)患者心血管事件和死亡风险,但对肾脏事件风险无显著影响。   Ricardo博士指出,健康生活方式对普通人群影响的研究较为常见,但未见作为CKD患者不良结局预测指标的评价研究。此外,虽然也一些针对单一风险因素如吸烟与慢性肾病进展,以及锻炼与死亡率相关性研究

  美国伊利诺伊大学的Ana C. Ricardo博士在2012年肾脏周上报告的一项初步研究结果显示,健康生活方式可降低慢性肾病(CKD)患者心血管事件和死亡风险,但对肾脏事件风险无显著影响。

  Ricardo博士指出,健康生活方式对普通人群影响的研究较为常见,但未见作为CKD患者不良结局预测指标的评价研究。此外,虽然也一些针对单一风险因素如吸烟与慢性肾病进展,以及锻炼与死亡率相关性研究,但未见有关多种健康生活方式因素综合影响的研究。

  为此,Ricardo博士及其同事对入组慢性肾功能不全队列(CRIC)研究的3,670例轻至中度肾病患者进行了4年随访研究,根据受试者健康生活方式评分,评估健康生活方式与临床结局的相关性。受试者健康生活方式评分由入组时下列因素评分(每个因素为1分)相加而成:目前不吸烟、参与适度锻炼(锻炼时间≥150分钟/周)、参与剧烈运动(锻炼时间≥75分钟/周)以及尿钠排出量<100 mEq/d。结局指标包括CKD进展(定义为估计肾小球滤过率下降≥50%或终末期肾病)、发生心血管事件(定义为心梗、卒中、心衰或外周动脉疾病)或死亡。应用多变量Cox比例风险回归模型,评估生活方式因素对上述结局的影响。

  结果显示,86%的受试者坚持1或2种健康生活方式,更多的女性、非西班牙裔白人和大学毕业生健康生活方式评分达到3分。健康生活方式评分为1分者心血管事件和死亡风险下降35%,评分为2或3分者风险进一步下降,分别下降45%和 44%。此外,健康生活方式评分为1分者CKD进展风险下降30%,但未达到统计学显著水平,评分为2或3分者也未见风险进一步下降(分别为24%和7%),其原因有待进一步分析。

  研究者承认该研究存在观察性设计等局限性,上述结果也仅是初步研究结果,更多的分析尚在进行中。

    

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