血液透析患者猝死相关因素分析  

Sudden death in hemodialysis patients related factors

作　　者：李涌泉 张欣洲[1,2] 王康 张万帆[1,2] 郭宝春 

机构地区：[1]深圳市人民医院 [2]暨南大学第二临床医学院肾内科,广东深圳518020

出　　处：《中国当代医药》2010年第20期5-6,8,共3页China Modern Medicine

摘　　要：目的:了解血液透析患者猝死的相关因素。方法:回顾性分析本院血液透析室5年间具有较完整病历资料的死亡患者93例,其中符合猝死标准的有25例。对比分析猝死患者(猝死组)和其他死亡患者(非猝死组)死亡前3个月的临床、实验室检查资料及死亡前6个月的超声心动图检查结果。以猝死为因变量对上述临床资料进行逐步多元回归分析。结果:猝死组患者合并糖尿病及每周透析时间小于8h的患者的比例显著高于非猝死组。猝死组患者死亡前1个月的平均透析前收缩压、平均每次透析超滤量均明显高于非猝死组。猝死组患者血清清蛋白、血红蛋白明显低于非猝死组,而超声心动图检查左房内径(LAD)、左室收缩末期内径(LVDs)较非猝死组明显增大。多元回归分析显示合并糖尿病、收缩压升高、平均透析超滤量、LAD及每周透析治疗小于8h是血液透析患者猝死的危险因素。结论:合并糖尿病、血压控制不佳、容量负荷增加和透析不充分是血液透析患者猝死的危险因素。Objective：To understand the sudden death in hemodialysis patients related factors.Methods：A retrospective analysis of our hemodialysis room 5 years,with more complete medical records of 93 cases of deaths of patients,which meet the standards of the 25 cases of sudden death.Comparative Analysis of sudden death （SD group） and other patients who died （non-sudden death group） died before 3 months of clinical,laboratory data and death of the first 6 months of echocar - diography results.To sudden death as the dependent variable on the clinical data stepwise multiple regression analysis. Re- sults：The sudden death in patients with diabetes and the weekly dialysis time was less than 8 hours,significantly higher than the proportion of patients with non-sudden death group.Sudden death in patients 1 month before death,the average systolic blood pressure before dialysis,the average for each ultrafiltration dialysis were significantly higher than non-sudden death group.Sudden death in patients serum albumin,hemoglobin was significantly lower than non -sudden death group, while echocardiography left atrial dimension （LAD）,left ventricular end systolic diameter （LVDs） was significantly larger than non-sudden death.Multiple regression analysis showed that diabetes mellitus,systolic blood pressure increased,the average dialysis ultrafiltration,LAD,and less than 8 hours per week dialysied was hemodialysied patients with risk factors for sudden death.Conclusion：Diabetes,poor blood pressure control,volume overload,and inadequate dialysis are hemodialysis patients risk factors for sudden death.

关 键 词：血液透析 猝死 危险因素 回归分析 

分 类 号：R692[医药卫生—泌尿科学]