西藏地区腹膜透析患者现状调查  

Current status of peritoneal dialysis patients in Tibet area

作　　者：党宗辉[1] 徐大民 许戎[1,2] 阿勇 罗磊[1] 次仁罗布[1] 贺艳[1] 李国梁[1] 张蕾[1] 

机构地区：[1]西藏自治区人民医院肾脏内科,拉萨850000 [2]北京大学第一医院肾内科北京大学肾脏病研究所,北京100034

出　　处：《肾脏病与透析肾移植杂志》2017年第5期447-450,454,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：西藏自治区自然科学基金项目(20152R-14-50)

摘　　要：目的:分析西藏地区腹膜透析患者现状,为提高腹膜透析质量提供依据。方法:回顾性分析2011年5月至2016年6月在西藏自治区人民医院接受腹膜透析治疗的患者的临床及实验室资料,用单因素COX回归分析腹膜炎及死亡事件的相关因素。结果:56例腹膜透析患者,导致终末期肾病的首要病因是肾小球肾炎(43例,76.8%)、其次为糖尿病肾病(4例,7.1%)。腹膜炎的发病率为1/35.8患者月,是导致技术失败的首要原因。第1、2、3年的患者生存率分别为95.8%、83.5%、79.9%,主要死亡原因是肺部感染和心功能不全。C反应蛋白与死亡风险增加显著相关(HR 1.03,95%CI 1.01~1.05,P=0.004)。结论:西藏地区腹膜透析患者进入终末期肾病的首要病因是肾小球肾炎。本组患者腹膜炎发生率偏高,导致死亡的主要原因是肺部感染和心功能不全。C反应蛋白升高是死亡的危险因素。Objective： To investigate the status of peritoneal dialysis patients treated with in Tibet area.Methodology： The clinical and laboratory data of the patients who performed peritoneal dialysis were retrospectively analyzed in our department between May,2011 and June,2016. Single variable Cox regression was used to analyze the risk factors associated with peritonitis and death. Results： During the study period,56 patients performed peritoneal dialysis in our department. The primary etiology of end stage renal disease was glomerulonephritis 43（ 76. 8%）,followed by diabetic nephropathy 4（ 7. 1%）. The incidence of peritonitis was 1/35. 8 patient-month,which was the primary cause of technique failure. The patient survival at the 1 st,2 nd,and 3 rd year was 95. 8%、83. 5% and 79. 9%,respectively. The major etiologies of death were pulmonary infection and cardiac insufficiency. Higher C-reactive protein level was significantly associated with death（ HR： 1. 03,95%CI： 1. 01-1. 05,P = 0. 004）. Conclusion： The primary etiology of end stage renal disease in Tibet area was glomerulonephritis. The incidence of peritonitis was higher than those reported by experienced centers. The major etiologies of death were pulmonary infection and cardiac insufficiency. Higher C-reactive protein level was significantly associated with death. Large sample study with longer follow-up is of interest.

关 键 词：腹膜透析 慢性肾脏病 腹膜炎 转归 

分 类 号：R459.5[医药卫生—治疗学]