维持性血液透析和腹膜透析患者死亡原因及预测因素分析  

Analysis of Death Causes and Predictive Factors in Patients Receiving Maintenance Hemodialysis and Peritoneal Dialysis

作　　者：郭东花[1] 刘文虎[2] 张东亮[2] 郭王[2] 王刚[2] 姜群[2] 廖云[2] 刘桂玲[2] 

机构地区：[1]北京市监狱管理局中心医院,100054 [2]北京友谊医院

出　　处：《中国全科医学》2007年第9期704-706,共3页Chinese General Practice

摘　　要：目的分析维持性血液透析(HD)与维持性腹膜透析(CAPD)患者的死亡原因及死亡预测因素,探讨影响维持透析患者长期生存的因素。方法选择1999年1月～2004年1月我院维持透析3个月以上的所有尿毒症患者进行回顾性分析,其中HD患者177例,CAPD患者224例。比较两组患者的病因诊断、死亡原因及死亡预测因素,记录随访患者的年龄、性别、原发病、透析龄,并记录患者开始透析时的血压、血红蛋白(Hb)、血尿素氮(BUN)、血肌肝(Scr)、钙磷乘积(Ca×P)、清蛋白(A)、总胆固醇(CHO)、三酰甘油(TG)、尿素清除指数(KT/V)等,应用Cox回归分析找出HD组和CAPD组各自的死亡预测因素。结果HD组死亡60例,CAPD组死亡81例,两组病因总体构成间差异有显著性意义(P<0.05);HD组与CAPD组死因构成间差异无显著性意义(P>0.05)。年龄、BUN、Scr、Ca×P、KT/V是HD组死亡预测因素(P<0.05),A、CHO、BUN、尿量、残肾KT/V是CAPD组的死亡预测因素(P<0.05)。结论HD组与CAPD组死亡主要原因均为心脑血管事件,两组间死亡预测因素构成相似,临床上应根据患者的具体情况来决定采用何种透析治疗方案。Objective To analyze the death causes and the death predictive factors in patients receiving maintenance of hemodialysis （HD） and peritoneal dialysis （PD） , and to study the influencing factors to long term survival in dialysis patients. Methods Retrospective analysis was carried out on all uremia patients receiving maintenance dialysis for more than 3 months in our hospitals in 5 years from January 1999 to January 2004. Among the patients 177 received HD and 224 received PD, comparison was done between the patients in two groups on the etiological diagnoses and death predictive factors; and the patients＇ age, sex, primary diseases, dialysis age, as well as the patients＇ blood pressure, death causes, the values of hemoglobin （ Hb）, blood urea nitrogen （ BUN）, serum creatinine （ Scr）, product of calcium and phosphorus （ Ca × P）, albumin （ A）, total cholesterol （CHO）, triglyceride （TG）, and （KT/V） were recorded. Cox regression analysis was conducted to find out the death predictive factors in HD and PD group. Results In HD group there were 60 patient died, and in PD group 81 ; there was a significant difference in total constituent ratio of etiology between the two groups （ P 〈 0. 05 ）. There was no significant difference. in constituent ratio of death cause between the two groups （ P 〉0. 05）. Age, BUN, Scr, Ca × P, KT/V were the death predictive factors for HD group （ P 〈 0. 05 ）. A, CHO, BUN, urine quantity, age were the death predictive factors for PD group （ P 〈 0. 05 ）. Conclusion The main death causes for HD and PD were cardiocerebral events. The constituent ratios in the two groups were similar; clinically the concrete conditions of a patient should be the basis for determining the dialysis measure for him.

关 键 词：血液透析 腹膜透析 死亡原因 预测因素 

分 类 号：R459.5[医药卫生—治疗学]