腹膜透析与血液透析患者心血管疾病患病率比较及影响因素分析  

Prevalence of cardiovascular disease in dialysis and relevance of cardiovascular risk factors

作　　者：邹荣[1] 贺立群[1] 肖方喜[1] 陈芳[1] 黄晓丽[1] 胡韬韬[1] 李红波[1] 万胜[1] 陈菁[1] 梁鸿卿[1] 熊飞[1] 

机构地区：[1]武汉市第一医院肾内科,430022

出　　处：《中华临床医师杂志（电子版）》2012年第18期94-97,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：武汉市卫生局临床医学科研项目(WX10B03;WX10C05;WX10D02)

摘　　要：目的观察统计我院腹膜透析中心与血液透析中心所有透析患者心血管疾病(CVD)患病率,并综合分析其发病的相关影响因素。方法调查所有透析患者主诉和体征及实验室检查、心电图、超声心动图等。结果 (1)所有透析患者冠心病(CAD)患病率为26.3%,左心室肥厚(LVH)患病率为63.1%,慢性充血性心力衰竭(CHF)患病率为42.6%,心律失常(CVA)患病率为43.2%;且CAD、LVH、CHF、CVA患病率随年龄增加而增加。(2)在透析时程<1年的透析患者中,CAD、LVH、CHF、CVA患病率分别为30.0%、63.3%、39.1%和30.7%;透析时程在1～5年的透析患者中,其各种CVD患病率分别为23.8%、56.5%、41.0%和39.4%;透析时程>5年的透析患者各种CVD患病率分别为34.8%、94.6%、55.4%和66.9%。(3)分层比较发现,血液透析(HD)与腹膜透析(PD)患者在各个年龄段CAD及LVH患病率均没有明显差异。>60岁的PD患者中,其CHF患病率高于HD患者,差异有统计学意义。同时,在>60岁的HD患者CVA患病率高于PD患者,差异有统计学意义。(4)在各个透析时程HD患者与PD患者CAD、LVH及CVA患病率没有明显差异。透析龄在1～5年组的PD患者CHF患病率高于HD患者,差异有统计学意义。结论 CVD仍然是威胁透析患者生命的主要疾病之一,深入探讨透析患者CVD的患病率,改善透析患者心血管状态,对于提高透析质量,改善透析患者预后具有重要意义。Objective To evaluate the prevalence of cardiovascular disease(CVD)and its association with cardiovascular risk factors in end-stage renal disease(ESRD)patients under maintenance hemodialysis(HD)and peritoneal dialysis(PD).Methods The symptoms,physical sign and chemical examination were obtained from 734 dialysis patients between 2010 and 2011.Results (1)The most prevalent pathological form of CVD was left ventricular hypertrophy(LVH),accounting for 63.1% of total patients.The prevalence of coronary artery disease(CAD),congestive heart failure(CHF),and cerebrovascular accidents(CVA)was 26.3%,42.6%,43.2%,separately.(2)In the first 1 year of dialysis,the prevalence of CAD,LVH,CHF,CVA was 30.0%,63.3%,39.1%,30.7%,separately.In the period of 1 to 5 years,the prevalence of CVD was 23.8%,56.5%,41.0%,39.4%;In the period over 5 years,the prevalence of CVD was 34.8%,94.6%,55.4%,66.9%.(3)The prevalence of CHF was significantly higher and the prevalence of CVA was lower in PD patients than that in HD patients.There was no significant difference in prevalence of other CVD diseases.(4)The prevalence of CHF was much higher in PD patients than that in HD patients in dialysis period of 1 to 5 year.Conclusions The cardiovascular risk is significantly increased in dialysis patients.Prevention and treatment of CVD of dialysis patients should be emphasized to improve the quality and long term prognosis of dialysis.

关 键 词：腹膜透析 肾透析 心血管疾病 患病率 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]