终末期肾病血液透析患者危险因素分析  

Risk factors for patients with end stage renal disease undergoing hemodialysis

作　　者：张睿[1] 姚伦[1] 宋国巍[1] 

机构地区：[1]吉林省人民医院,吉林长春130021

出　　处：《吉林医学》2009年第17期1885-1887,共3页Jilin Medical Journal

摘　　要：目的:探讨影响终末期肾病(ESRD)血液透析患者生活质量及长期存活的各种危险因素及防治方法。方法:选择42例终末期糖尿病肾病血透患者和同期50例相同年龄段非糖尿病血透患者,分别观察死亡原因、存活率、并发症及血生化改变。结果:①糖尿病肾病组1年和2年存活率分别为81%和71%。主要死因是心血管病变,其次是感染。②首次透析时的肌酐值与病死率成正比。③影响透析效果的主要并发症是心血管病变(86%)、高血压(88%)、透析低血压(31%)、感染(50%),与非糖尿病肾病组比较有显著性差异。结论:糖尿病肾病终末期患者较非糖尿病患者应更早进行血透,控制两次透析期间的体重增加<2.5kg,减少透析时血糖波动,防治并发症是减少危险因素,提高存活率及生活质量的关键。Objective To investigate the risk factors that influence the quality of life and long -term survival of the end stage renal disease （ESRD） patients undergoing hemodialysis, as well as the prophylactic measures. Method We selected ESRD patients with diabetic nephropathy （ DN ） undergoing hemodialysis （ n = 42 ） and those ESRD without DN （ n = 50 ） with similar age distribution. The cause of death,survival rate,complications and the blood biochemistry values changes were observed. Results （1）The survival rate of the patients with DN in the first and second years was 81% and 71% , respectively. The first cause of death was cardiovascular events, and the second was infections. （2）The initial level of serum creatinine was positively related to mortality. （3）The main complications that influenced the outcome of dialysis in patients with DN were cardiovascular diseases （86%）, hypertension （88%） ,intradialytie hypotension （31%） and infections （50%）. There were significant differences between the patients with DN and those without DN. Conclusion In order to decrease the risk factors and improve the quality of life and long - term survival rate of the ESRD patients caused by DN, it is very important to start hemodialysis earlier than those without DN. The interdialytic weight gain should be controlled within 2. 5kg, and maintain a good intradialytic glueomie control, the complications should be prevented and treated. Key Words ：

关 键 词：终末期肾病 糖尿病肾病 血液透析 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]