背景：冠狀動脈心臟病（冠心病）是長期血液透析病患死亡的最重要原因，但至今透析病患冠心病的危險因子，仍未被建立。方法：我們設計了一個多中心的橫斷面研究，包括台灣地區12個血液透析中心共995位病患，試圖找出冠心病的盛行率，及其可能的危險因子。研究進行之前，所有患者均暫停降血脂藥物兩周。我們共研究三十個不同變項，以找出其與冠心病的關聯性。結果：995位病患（男／女：499/496）的平均年齡56.4±12.3歲，平均透析時間59.8±51.2月。血脂狀況為cholesterol 179.4±44.5mg/dL、triglyceride 173.6±145.0mg/dL、high-density lipoprotein cholesterol 40.9±13.2mg/dL、low-density lipoprotein cholesterol 89.4±38.6，mg/dL。冠心病、糖尿病及高血壓的盛行率分別為24.0%、24.1%和61.0%。多變異數回歸分析發現，在傳統的冠心病危險因子中，只有年齡與冠心病盛行率有顯著的相關性。同時，我們發現數個可能的新危險因子，包括較低的apolipoprotein A-I、較低的肌酸酐深度、左心室肥厚、及心胸廓比(cardiothoracic ratio)大於或等於55%。結論：我們的研究指出，並非傳統一般群眾的冠心病危險因子，都適用於長期血液透析病患。我們也發現數個新的危險因子，也許正是透析的病患過高的冠心病風險的可能原因，然而，這樣的發現仍須要更多的長期追蹤研究來印證。 Backgrounds: Coronary heart disease (CHD) is the most common cause of mortality/or chronic hemodialysis (HD) patients, ‘et the risk factors for CHD have not been well established. Methods: We conducted a multi-center cross sectional survey to investigate the prevalence of CHD and its associated risk factors in 995 chronic HD patients recruited front twelve HD centers in Taiwan. Patients had discontinued taking lipid-lowering agents for at least two weeks before entry. We calculated prevalence of CHD and studied the association between it and thirty different possible risk factors. Results: In total, we studied 995 patients (M/F: 499/496) with a mean age of 56.4±12.3 years having undergone HD for ass average of 59.8±51.2 months. Lipid profiles showed cholesterol 179.4±44.5 mg/dL, triglyceride 173.6±145.0 mg/dL, high density lipoprotein cholesterol 40.9±13.2 mg/dL, and lose-density lipoprotein cholesterol 89.4±38.6 mg/dL. CHD, diabetes and hypertension prevalence rates were 24.0%, 24.1% and 61.0%, respectively. Results of our multivariate logistic regression analysis showed that, of the conventional CHD risk factors in the general population, only old age could he significantly associated with CHD. However, we did find some new possible risk factors for CHD-low apolipoprotein A-1 and creatinine levels, left ventricular hypertrophy, and cardiothoracic ratio?55%. Conclusions: Our study suggests that not all of the conventional CHD risk factors for the general population can be considered risk/actors/or chronic HD patients, and there are others that mi gist contribute to a higher risk of CHD
