老年腹膜透析患者生存率和临床特点的研究  

Survival of elderly patients on peritoneal dialysis： a retrospective study of 180 patients in one center

作　　者：李芸[1] 朱彤莹[1] 莫逸[1] 

机构地区：[1]复旦大学附属华山医院肾内科,上海200040

出　　处：《老年医学与保健》2009年第1期27-29,共3页Geriatrics & Health Care

摘　　要：目的研究本中心老年维持性腹膜透析患者生存率和临床特点。方法回顾性分析2004年1月至2008年9月新进入我院腹膜透析中心行正规随访的维持性腹膜透析患者。根据进入腹膜透析治疗时的年龄分为A组（年龄〉165岁）和B组（年龄〈65岁）。比较两组患者生存率以及贫血、钙磷代谢、脂代谢、炎症等方面的实验室指标。初步分析残肾功能和各组生存率的关系。用Kaplan—Meier检验进行生存分析。结果本研究共包括180例维持性腹膜透析患者。A组累积生存率低于B组（P〈0．05）。A组中无残肾功能患者死亡率高于有残肾功能者。A组的血磷、钾、白蛋白、前白蛋白水平均低于B组；而A组血CRP水平高于B组。结论老年腹膜透析患者的生存率低于年轻患者，有无残肾功能与老年患者的生存率高低有关。老年患者营养水平较年轻患者差，炎症反应较年轻患者高。Objective To analyze the survival of aged patients older than 65 years on maintenance peritoneal dialysis （PD） from January 2004 to September 2008. Methods A retrospective study was performed in 180 patients on continuous ambulatory peritoneal dialysis. They were divided into two age groups： Group A （≥65 years） and Group B （〈65 years）. The survival rate was compared between the two groups. Laboratory parameters including hemaglobin, calcium, phos- phorus, parathyroid hormone （PTH）, cholesterol, triglyceride, low-density lipoprotein, high-density lipoproteinand C-reactive protein were evaluated. Patients were followed up for 5 years. Results During the 5-year follow-up period, the mean survival rate was higher in Group B than in Group A. In Group A, the survival rate of patients with significant amount residual renal function was higher. Serum phosphorus, potassium, albumin and pre-albumin levels were lower in Group A than those in Group B, while CRP level was higher in Group A. Conclusions Compared with younger PD patients, the survival rate of elderly patients was significantly lower. The residual renal function was an important factor influencing the survival rate. The nutritional state of elderly patients was worse than that of younger patients. The inflammation level was higher in elderly patients compared to younger patients.

关 键 词：腹膜透析 存活率 炎症 营养 肾功能衰竭 老年人 

分 类 号：R459.5[医药卫生—治疗学]