维持性血透患者心力衰竭危险因素的Logistic回归分析  

Logistic regression analysis of risk factors for heart failure in hemodialysis patients

作　　者：赵国忠[1] 陈晨[1] 黄赞维[2] 冯小兰[2] 瞿龙[1] 宋斌[3] 

机构地区：[1]四川省科学城医院心内科,四川绵阳621900 [2]四川省科学城医院肾内科,四川绵阳621900 [3]四川大学华西医院肾内科,成都610041

出　　处：《第三军医大学学报》2008年第19期1855-1857,共3页Journal of Third Military Medical University

摘　　要：目的探讨维持性血透患者发生心力衰竭的危险因素。方法回顾性分析145例维持性血透患者的临床资料,对照心衰组与非心衰组病例,用条件Logistic回归法分析心力衰竭发生与患者性别、年龄、肾衰竭基础病因等22项有关因素的相关性。结果单因素分析表明,与心力衰竭发生有关的因素有年龄、糖尿病肾病、高血压肾损害、透析总持续时间、每周促红素人均使用量、尿素清除指数(KT/V值)、高血压、低血红蛋白、低血清白蛋白、高血肌酐、透析间期体重增加过快、并发感染、动静脉内瘘、并存有其他心脏器质性病变等。引入多因素Logistic回归方程的变量是年龄、糖尿病肾病、高血压肾损害、尿素清除指数、高血压、低血红蛋白、低血清白蛋白、透析间期体重增加过快、并发感染、动静脉内瘘、并存有其它心脏器质性病变等。结论年龄、肾衰竭基础病因、透析不充分、高血压、低血红蛋白、低血清白蛋白、透析间期体重增加过快、并发感染、动静脉内瘘、并存有其他心脏器质性病变是维持性血透患者发生心力衰竭的危险因素。Objective To determine risk factors for heart failure in hemodialysis patients. Methods The relationship of heart failure with 22 parameters including sex, age, base disorders of kidney failure in 145 patients undergoing hemodialysis were analyzed by conditional logistic regression. Results Single parameter analysis indicated that heart failure was related with age, diabetic kidney disorder, hypertension-related kidney damage, time period of hemodialysis, dose of EPO usage per week, the ratio of KT/V, blood pressure, low Hb, low albumin, high level of SCR, body weight change, size of arteriovenous fistula, as well as other cardiac disorders. The parameters analyzed by muhiparameter logistic regression included age, diabetic kidney disorder, hypertension-related kidney damage, the ratio of KT/V, blood pressure, low Hb, low albumin, body weight change, size of arteriovenous fistula, infection, as well as other cardiac disorders. Conclusion Age, the diseases causing kidney failure, insufficient hemodialysis, blood pressure, low Hb, low albumin, body weight change, infection, size of arteriovenous fistula and other cardiac disorders are risk factors for heart failure in maintenance hemodialysis patients.

关 键 词：血液透析 心力衰竭 危险因素 条件LOGISTIC回归 

分 类 号：R195.4[医药卫生—卫生统计学] R459.5[医药卫生—卫生事业管理]