| 黄群,李德天.腹膜透析患者死亡危险因素分析[J].安徽医药,2016,20(4):719-722. |
| 腹膜透析患者死亡危险因素分析 |
| Analysis of risk factors of death in patients with peritoneal dialysis |
| 投稿时间：2015-11-16 |
| DOI： |
| 中文关键词: 腹膜透析 死亡危险因素 |
| 英文关键词: peritoneal dialysis factors of death |
| 基金项目: |
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| 中文摘要: |
| 目的 分析腹膜透析患者的死亡危险因素,指导临床诊治。方法 回顾性分析该院2008年6月—2013年9月收治的并在该院初次行腹膜透析、随访3个月以上的患者143例,其中死亡35例,存活108例,存活患者中肾移植6例,拔管12例,失访2例,采用多变量COX回归分析方法分析患者接受腹膜透析前各项临床指标对其预后的影响。结果 原发病中,以慢性肾小球肾炎为主,63例(44.06%),糖尿病肾病46例(32.17%),高血压肾损伤21例(14.68%),马兜铃酸肾病5例(3.5%),止痛剂肾病3例(2.1%),多囊肾2例(1.4%),血管炎肾损伤、梗阻性肾病各1例(0.7%),原因不明的患者1例(0.7%)。死亡患者中,死于心血管疾病10例(28.57%),脑血管疾病7例(20%),腹膜炎5例(14.29%),肺内感染4例(11.43%),消化道出血2例(5.71%),原因不明4例(11.43%), 肿瘤、营养不良、多器官功能衰竭各1例(2.86%)。总体透析时间(28.3±16.42)个月,死亡组平均透析时间(24.53±17.13)个月。单因素分析显示,进入腹膜透析时的年龄大、既往脑血管疾病病史为腹膜透析患者死亡的危险因素,再进行多因素COX回归,结果显示透析前高龄、高磷为腹膜透析患者死亡的独立危险因素。结论(1)腹膜透析患者原发病仍是以慢性肾小球肾炎为主(44.06%),符合我国目前慢性肾功能不全原发病构成；(2)该透析中心腹膜透析患者死亡疾病构成、生存率与国际报道接近；(3)腹膜透析前患者高龄、血磷升高为腹膜透析患者死亡的独立危险因素。 |
| 英文摘要: |
| Objective Analysis of risk factors of death in patients with peritoneal dialysis to guide the clinical diagnosis and treatment.Methods 143 cases who recived first row of peritoneal dialysis, admitted in our hospital form June 2008 to September 2013,were selected. All these cases were followed up for more than 3 months, among which 35 cases died and 108 cases survived. In the survival cases, 6 were treated with renal transplantation, 12 cases with extubation , and 2 cases were lost of follow-up.Multivariable COX regression analysis was used to analyze various clinical indicators of the prognosis of patients undergoing peritoneal dialysis. Results In the primary disease, 63 cases were chronic glomerulonephritis (44.06%), 46 cases diabetic nephropathy (32.17%), 21 cases hypertensive renal injury (14.68%), 5 cases aristolochic acid nephropathy (0.7%), 3 cases analgesic nephropathy (2.1%), 2 cases polycystic kidney disease(1.4%),1 case vasculitis and renal injury,1 case obstructive nephropathy(0.7%), and 1 cases unknown disease (0.7%).Among the dead, 10 cases died of cardiovascular disease (28.57%),7 cases of cerebrovascular disease (20%), 5 cases of peritonitis (14.29%), 4 cases of lung infection (11.43%), 2 cases of gastrointestinal bleeding (5.71%), 4 cases of unknown causes (11.43%), while tumor, malnutrition, multiple organ failure each has 1 case (2.86%). The overall duration of dialysis is(28.3±16.42) months, whereas the average duration of dialysis in death group is(24.53±17.13) months. Single factor analysis showed that the risk of death in patients with peritoneal dialysis fell into the old age, and history of cerebral vascular disease.The multivariate COX regression showed that advanced age and higher phosphorus were independent risk factors for mortality in patients with peritoneal dialysis.Conclusions(1)Chronic glomerulonephritis is still the maindisease in patients with peritoneal dialysis, which is in line with current form of chronic kidney disease in China;(2)The survival rate and disease constitution of patients with peritoneal dialysis in our dialysis center are close to international reports;(3)Advanced age and higher phosphorus were independent risk factors for mortality in patients with peritoneal dialysis. |
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