老年维持性血液透析患者患恶性肿瘤的影响因素分析  

Study on influencing factors of malignant tumor in elderly patients withmaintenance hemodialysis

作　　者：张立华[1] 高永宁[1] 马慧鹏[1] 王柱[2] ZHANG Lihua;GAO Yongning;MA Huipeng;WANG Zhu(Department of Fluid Dialysis,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Gynecology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院血液透析科,河北石家庄050000 [2]河北医科大学第二医院妇科,河北石家庄050000

出　　处：《东南大学学报（医学版）》2023年第4期607-612,共6页Journal of Southeast University(Medical Science Edition)

基　　金：河北省医学科学研究课题计划(20211812)。

摘　　要：目的:探究老年维持性血液透析(MHD)患者患恶性肿瘤(MT)的影响因素。方法:选择2021年1月至12月河北医科大学第二医院收治的372例老年MHD患者为研究对象,将MHD期间并发MT的患者作为MT组(41例),未并发MT的患者作为N-MT组(331例);分析影响老年MHD患者发生MT的相关因素;采用多因素Logistic回归分析影响老年MHD患者MT发生的危险因素。结果:老年MHD患者MT发生率为11.02%。N-MT组与MT组性别、家族MT史、吸烟史、合并高血压、合并糖尿病的差异均无统计学意义(P>0.05),年龄、体质量指数(BMI)、尿量、透析龄、白蛋白、全段甲状旁腺激素(iPTH)、血红蛋白(Hb)、尿素清除指数(Kt/v)及总淋巴细胞计数(TLC)理想百分率差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,透析龄>48个月、白蛋白≥30 g·L^(-1)、TLC理想百分率<70%是老年MHD患者合并MT的独立危险因素(P<0.05)。结论:老年MHD患者MT发生率约为11.02%,透析龄>48个月、白蛋白≥30 g·L^(-1)、TLC理想百分率<70%是老年MHD患者合并MT的独立危险因素。Objective:To investigate the current situation and influencing factors of malignant tumor(MT)in elderly maintenance hemodialysis(MHD)patients.Methods:A total of 372 elderly MHD patients admitted to the Second Hospital of Hebei Medical University from January 2021 to December 2021 were selected as the study subjects;the clinical data of elderly MHD patients were collected;patients with MT during MHD were treated as MT group(41 cases),and patients without MT were treated as N-MT group(331 cases);the related factors affecting MT in elderly MHD patients were analyzed;multivariate Logistic regression was applied to analyze the risk factors of MT in the elderly MHD patients.Results:The incidence of MT in elderly MHD patients was 11.02%;there was no obvious difference between N-MT group and MT group in gender,family MT history,smoking history,hypertension and diabetes(P>0.05);there were obvious differences between N-MT group and MT group in age,body mass index(BMI),urine volume,dialysis age,albumin,intact parathyroid hormone(iPTH),hemoglobin(Hb),urea clearance index(Kt/v)and ideal percentage of total lymphocyte count(TLC)(P<0.05);multivariate Logistic regression analysis showed that dialysis age>48 months,albumin≥30 g·L^(-1),and ideal percentage of TLC<70%were independent risk factors for elderly MHD patients with MT(P<0.05).Conclusion:The incidence of MT in elderly MHD patients is about 11.02%.Among them,dialysis age>48 months,albumin≥30 g·L^(-1),and the ideal percentage of TLC<70%are independent risk factors for elderly MHD patients with MT.

关 键 词：维持性血液透析 恶性肿瘤 影响因素 老年人 

分 类 号：R459[医药卫生—治疗学]