关键词:

枸橼酸钠, 血液透析, 危险因素, 预测模型

Abstract:

Objective To investigate the risk factors of single⁃stage sodium citrate for coagulation in hemo⁃ dialysis（HD），and to establish a prediction model. Methods A total of 240 patients with high⁃risk bleeding who received 640 HD treatments in the Second Affiliated Hospital of Nanchang University from January 2018 to July 2021 were retrospectively analyzed. The relevant parameters of anticoagulant treatment were analyzed. The risk factors of coagulation were analyzed by univariate and multivariate logistic regression. The risk prediction model was established according to the results of logistic regression analysis，the nomogram of the prediction model was established by R language，and the receiver operator characteristic curve（ROC）was used to analyze the predic⁃ tion value of the regression model. Results The proportion of 640 cases with single⁃stage coagulation was 25.93%. Logistic regression analysis showed that vascular pathway，total ultrafiltration volume，ratio of sodium citrate pump⁃ ing speed to blood flow（T/Q），diet，2h B free Ca2+ concentration and venous pressure were independent risk factors for coagulation. The prediction model of single⁃stage HD treatment was established based on the above findings. Using ROC curve analysis，the area under curve（AUC）was 0.996 and 0.661 was the cut⁃off point，the sensitivity was 0.983 and the specificity was 0.994. Conclusion The model of coagulation risk established by logistic regres⁃ sion model could make a preliminary judgment on coagulation occurs in single⁃stage HD treatment.

Key words:

sodium citrate, hemodialysis, risk factors, prediction model