维持性血液透析患者住院相关因素分析  

Related factors of hospitalization in maintenance hemodialysis patients

作　　者：贾丽芳[1] 周培一[1] 冯悦民[1] 王甲正[1] 

机构地区：[1]首都医科大学大兴医院肾内科,北京102600

出　　处：《山西医科大学学报》2013年第12期962-965,共4页Journal of Shanxi Medical University

摘　　要：目的分析维持性血液透析患者住院原因及其相关因素。方法对2011—06～2013—06首都医科大学大兴医院85例长期维持性血液透析患者进行回顾性分析，总结患者住院原因，比较住院和非住院患者的年龄、透析龄、体重指数（BMI）、血红蛋白（Hb）、透析前血肌酐、透析前血钾、血浆白蛋白（Alb）、透析前血钙、透析前血磷、全段甲状旁腺激素、尿素氮下降率（URR）和尿素清除指数（KT／V）等临床指标，利用多元逐步回归方法分析患者住院的相关危险因素。结果24个月中，85例患者中33例有住院记录，共住院79次。住院的主要病因是心血管疾病、感染和脑血管疾病。住院组患者体重指数、血红蛋白和血浆白蛋白水平显著低于非住院组[BMI：（20．91±2．10） vs （22．95±2．80）kg/m^2；Hb：（94．94±12．95） vs （108．51±7．80）g/L；Alb：（29．91±3．48） vs （36．88±2．25）g/L]。多元逐步回归分析显示，低体重指数和低白蛋白是影响血液透析患者住院的危险因素（β=-0．323和-0．736）。结论心血管疾病是血液透析患者住院的首要原因，其次感染和脑血管疾病。低体重指数和低自蛋白是住院的主要危险因素。Objective To investigate the causes of hospitalization and its related risk factors in maintenance hemodialysis（MHD） pa-tients. Methods A total of 85 MHD patients were enrolled in this study. Body mass index（BMI） ,dialysis age, hemoglobin, serum creatinine, serum potassium, serum calcium, serum phosphorus, plasma albumin, immunoreactive parathyroid hormone （ iPTH）, urea re-duction rate（URR） and urea clearance index （KT/V） were compared between hospitalization group and outpatient group. The main causes and its related risk factors for hospitalization were reviewed. Results In the 24-month observation period, 33 of 85 patients were hospitalized totally for 79 times. The main causes of hospitalization were cardiovascular diseases, infection and cerebrovascular diseases. BMI,hemoglobin and plasma albumin were lower in hospitalization group than those in outpatient group[ BMI： （20.91± 2.10 ） vs （ 22.95 ± 2.80 ） kg/m^2 ; hemoglobin ： （ 94.94 ± 12.95 ） vs （ 108.51 ± 7.80 ） g/L; plasma albumin ： （ 29.91 ± 3.48 ） vs （36.88 ± 2.25 ）g/L]. Stepwise multivariate regression analysis showed that the lower BMI and the lower plasma albumin were the main risk factors for hospitalization in MHD patients （β = -0. 323 and -0. 736）. Conclusion The main causes for hospitalization in MHD patients are cardiovascular diseases,infection and eerebrovascular diseases. The lower BMI and the lower plasma albumin are the main risk factors for hospitalization in MHD patients.

关 键 词：血液透析 住院 危险因素 

分 类 号：R692[医药卫生—泌尿科学]