2016~2019年山西省血液透析死亡患者流行病学调查  

Epidemiological survey of death in hemodialysis patients of Shanxi Province from 2016 to 2019

作　　者：廖智菲 焦元野 樊佩琦 武玲宇 郭罡玲 李静[1,2] 王利华 Liao Zhifei;Jiao Yuanye;Fan Peiqi;Wu Lingyu;Guo Gangling;Li Jing;Wang Lihua(Department of Nephrology,Second Hospital of Shanxi Medical University;Blood Purification Quality Control Center,Medical Quality Control Management Center of Shanxi Provincial Health Commission,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院肾内科,太原030001 [2]山西省卫健委医疗质量控制管理中心血液净化质量控制中心,太原030001

出　　处：《中华肾病研究电子杂志》2021年第5期241-245,共5页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：山西卫生计生委科研课题(2017051)。

摘　　要：目的回顾性分析2016~2019年山西省血液透析(HD)患者资料,为提高血液透析质量提供数据支持。方法通过全国血液净化病例登记系统收集2016~2019年山西省所有开展血液净化治疗的医疗机构网上直报的HD患者病例资料,分为老年组(≥60岁)和青中年组(<60岁),分析其死亡年龄、透析龄、年病死率、原发疾病、死亡原因等。结果2016~2019年山西省HD患者年病死率为5.3%~6.1%。透析龄范围为0~290个月,中位透析龄为31个月。透析龄不足1年的死亡患者占18.6%。死亡高峰在透析第5~10年。糖尿病肾病的年病死率最高(9.5%),其次为高血压肾损害(5.4%)、原发性肾小球疾病(3.6%)。在老年组中糖尿病肾病病死率占首位(34.2%),而在青中年组原发性肾小球疾病占首位(29.6%)。第一位死亡原因是心血管事件(38.4%),其次为脑血管事件(25.1%)、感染(7.2%)和消化道出血(4.3%)等。老年组的首位死因是心血管事件(30.3%),而青中年组的首位死因为脑血管事件(26.0%)。结论山西省HD死亡患者年病死率整体呈下降趋势,死亡患者平均透析龄呈延长趋势。HD的糖尿病肾病患者年病死率最高,以老年患者居多。心血管事件病死率呈下降趋势,但仍是HD患者死亡的首位原因,亦是老年患者的第一位死亡原因。脑血管事件年病死率有所上升,在青中年组尤为显著。Objective To retrospectively analyze data of death in hemodialysis(HD)patients of Shanxi Province from 2016 to 2019,so that support can be provided for improving the quality of HD.Methods Through the Chinese National Renal Data System(CNRDS),data were collected from the HD patients directly reported online by all medical institutions that carry out blood purification treatment in Shanxi Province from 2016 to 2019.The patients were divided into elderly group(≥60 years old)and young-middle-aged group(<60 years old).Analyses were made for age at death,dialysis age,annual mortality rate,primary disease,and cause of death,etc.Results The annual mortality rate of HD patients in Shanxi Province from 2016 to 2019 ranged from 5.3%to 6.1%.The age range of dialysis was 0-290 months,with a median dialysis age of 31 months.The mortality rate of patients who had started dialysis for less than 1 year accounted for 18.6%.The mortality rate peaked in patients who had started dialysis for 5 to 10 years.The annual mortality rate was highest in diabetic nephropathy(9.5%),followed by hypertensive renal damage(5.4%)and primary glomerular diseases(3.6%).In the elderly group,the mortality rate was highest in diabetic nephropathy(34.2%),while in the young-middle-aged group,the mortality rate was highest in primary glomerular diseases(29.6%).The first cause of death was cardiovascular events(38.4%),followed by cerebrovascular events(25.1%),infection(7.2%),and digestive tract bleeding(4.3%).The first cause of death was cardiovascular events in the elderly group(30.3%),but was cerebrovascular events in the young-middle-aged group(26.0%).Conclusion The annual mortality rate of HD patients in Shanxi Province was on the decline,and the average dialysis age of the dead patients was prolonged.HD patients with diabetic nephropathy had the highest annual mortality rate,who were mostly elderly patients.Although the mortality rate of cardiovascular events was on the decline,it was still the first cause of death in the HD patients,and also in the e

关 键 词：血液透析 年病死率 流行病学 

分 类 号：R47[医药卫生—护理学]