老年维持血液透析患者恶性肿瘤发病的相关因素分析  

Analysis of Related Factors of Malignant Tumor in Elderly Maintenance Hemodialysis Patients

作　　者：张国锐[1] 贾林[1] 赵丹[1] 杨晓萍[1] ZHANG Guo-rui;JIA Lin;ZHAO Dan;YANG Xiao-ping(Department of Nephrology,the First Affiliated Hospital of Shihezi University,Shihezi 832000,Xinjiang,China)

机构地区：[1]石河子大学医学院第一附属医院肾病科,新疆石河子832000

出　　处：《医学信息》2022年第10期113-116,共4页Journal of Medical Information

摘　　要：目的观察老年维持血液透析患者发生恶性肿瘤的情况,分析发生恶性肿瘤的高危因素,以期为制定老年维持血液透析患者恶性肿瘤预防方案提供依据。方法回顾性分析2016年1月-2020年12月在石河子大学第一附属医院行维持性血液透析的325例老年患者的临床资料,将透析期间筛查出恶性肿瘤的患者设为观察组,未发生恶性肿瘤患者设为对照组。分析维持性血液透析患者肿瘤部位及构成情况,采用单因素及多因素分析老年维持血液透析患者发生恶性肿瘤的危险因素。结果老年维持血液透析患者恶性肿瘤发生率为12.92%,以肾癌、甲状腺癌、肺癌为主;单因素分析显示,两组年龄、BMI、透析时间、尿量、白蛋白水平、Hb水平、iPTH水平、Kt/v、TLC理想百分率比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄≥70岁、BMI<23 kg/m2、透析时间≥3年、白蛋白水平<35 g/L、Kt/v<1.2、Hb<110 g/L、iPTH≥300 pg/ml、TLC理想百分率<70%为老年维持血液透析患者发生恶性肿瘤的高危因素。结论老年维持血液透析患者发生恶性肿瘤的几率较高,与患者透析时间长、营养状况差、免疫功能受损关系、尿毒症毒素作用有密切关系。Objective To observe the occurrence of malignant tumors in elderly patients with maintenance hemodialysis and analyze the risk factors for malignant tumors,so as to provide the basis for formulating the prevention scheme of malignant tumors in elderly patients with maintenance hemodialysis.Methods The clinical data of 325 elderly patients undergoing maintenance hemodialysis in the First Affiliated Hospital of Shihezi University from January 2016 to December 2020 were retrospectively analyzed.Patients with malignant tumors screened during dialysis were set as observation group,and patients without malignant tumors were set as control group.The tumor location and composition of maintenance hemodialysis patients were analyzed.Univariate and multivariate analysis were used to analyze the risk factors of malignant tumors in elderly maintenance hemodialysis patients.Results The incidence of malignant tumors in elderly maintenance hemodialysis patients was 12.92%,mainly renal carcinoma,thyroid carcinoma and lung cancer.Single factor analysis showed that there were significant differences in age,BMI,dialysis time,urine volume,albumin level,Hb level,iPTH level,Kt/v and TLC ideal percentage between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age≥70 years old,BMI<23 kg/m2,dialysis time≥3 years,albumin level<35 g/L,Kt/v<1.2,Hb<110 g/L,iPTH≥300 pg/ml,TLC ideal percentage<70%were risk factors for malignant tumors in elderly MHD patients.Conclusion The incidence of malignant tumor in elderly maintenance hemodialysis patients is high,which is closely related to long dialysis time,poor nutritional status,impaired immune function and uremic toxins.

关 键 词：维持血液透析 恶性肿瘤 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学]