268例维持性血液透析患者长期生存分析

Long-term Survival Analysis of 268 Patients with Maintenance Hemodialysis

目的了解维持性血液透析(maintenance hemodialysis,MHD)患者的临床流行病学资料、长期生存率及其影响因素。方法回顾性分析在我院确诊为终末期肾脏疾病(end-stage renal disease,ESRD)且原发病因明确的行血液透析(hemodialysis,HD)治疗患者的性别、年龄、原发病因分布、治疗的转归、长期生存率及其影响因素。结果MHD患者中死亡73例(27.24%),目前仍在我院行HD治疗者44例(16.42%);MHD患者的1年存活率为91.65%,3年存活率为77.77%,5年存活率为59.37%,中位生存时间7.503年;性别不影响患者的长期生存率,但开始HD治疗时年龄≥50岁,原发病因为高血压肾损害和糖尿病肾病,以及每周透析2次或少于2次的患者死亡率相对较高。结论本组患者中原发性肾小球疾病是导致ESRD的最常见原因,开始HD治疗时年龄≥50岁,原发病为高血压肾损害和糖尿病肾病者,以及透析不充分是患者死亡的危险因素。

Objective To analyze the clinical epidemiologie data,long-term survival rate and it＇ s influencing factors of patients with maintenance hemodialysis（MHD）. Methods We retrospectively studied the clinical data（ sexuality, age, cause of disease, prognosis,long-term survival rate and it＇ s influencing factors） of end-stage renal disease patients with MHD. Results Among the MHD patients ,27.24% of them died, 16.42% of them were still treated in hospital. Survival rates of 1,3,5-year in patients with MHD were 91.65 % , 77.77 % ,59.37 % respectively. The risk factors were aged, diabetes, hypertension, insufficiency of HD. Conclusions in these ESRD patients, primary glomerular disease was the most common cause. Aged, original disease as diabetes and hypertension,insufficiency of HD were risk factors of death.