中文摘要：

目的探讨腹膜透析（腹透）患者发生主动脉弓钙化的危险因素，及主动脉弓钙化对维持性腹膜透析患者预后的影响。方法采用回顾性分析的研究方法，2011年1月1日至2013年12月31日期间上海市第六人民医院的177例维持性腹膜透析患者被纳入研究。按照是否合并主动脉弓钙化将患者分为钙化组（66例）和无钙化组（111例）。收集患者临床资料，评估残余肾功能和透析充分性，采用胸部X线检查评估主动脉弓钙化程度。用二元logistics回归法分析主动脉弓钙化的独立危险因素；Kaplan．Meier生存曲线法分析患者生存预后的影响因素；多变量Cox回归法分析患者死亡风险的独立危险因素。结果177例腹膜透析患者主动脉弓钙化的发生率为37．29％（66／177）。血磷升高是主动脉弓钙化的独立危险因素（0R=54．69，95％CI：10．01—298．65，P〈0．01）。轻度与中度＋重度钙化组患者的生存率均低于无钙化组。中度＋重度主动脉弓钙化是腹透患者全因死亡及心血管疾病死亡的独立危险因素，风险比分别为无钙化组患者的3．779倍和5．636倍。结论高磷血症是主动脉弓钙化的独立危险因素；轻度与中度＋重度主动脉弓钙化患者的生存率均低于无钙化患者；中度＋重度主动脉弓钙化是腹膜透析患者全因死亡及心血管疾病死亡的独立危险因素。

英文摘要：

Objective To retrospectively study the risk factors of aortic arch calcificationand its influence on the survival prognosis of maintenance peritoneal dialysis patients. Methods One hundred seventy-seven cases of maintenance peritoneal dialysis patients were enrolled, including 66 cases of aortic arch calcification cases. Their general dialysis data were collected for the evaluation of dialysis adequacy and residual renal function, and their chest X-rays were recorded to assess the degree of aortic arch calcification. The two variables Logistics regression was used to analyze independent risk factors of aortic arch calcification; Kaplan- Meier analysis was used to analyze the influence on prognosis of dialysis patients; and multivariate COX regression was employed to analyze independent risk factors of death in dialysis patients. Results Among the 177 selected cases of peritoneal dialysis patients, 66 cases （37.29%） presented with aortic arch calcification. Elevated serum phosphorus was an independent risk factor of aortic arch calcification （OR=5d.69,95%CI： 10.01-298.65, P 〈 0.01）. The probability of survival in patients with mild and moderate （severe） calcification of aortic arch was less than those without calcification. Moderate （severe） calcification of aortic arch was the independent risk factor of all-cause mortality and cardiovascular disease mortality, whose hazard ratios in patients with calcification were 3.779 times and 5.636 times of those in patients without calcification respectively. Conclusions Hyperphosphatemia is an independent risk factor promoting the development of calcification of aortic arch. The probability of survival in patients with mild and moderate （severe） calcification of aortic arch is less than those without calcification; moderate （severe） calcification of aortic arch is the independent risk factor of all- cause mortality and cardiovascular disease mortality.