尿毒症患者透析间期体重获得与预后的关系

The relationship analysis of interdialytic weight gain and prognosis

目的 研究血液透析患者透析间期体重获得量 (IDWG % )与患者预后的关系。方法 回顾性研究我中心 1995年至 2 0 0 3年期间规律血液透析的患者 14 4例。计算 5年存活率、半数生存期 ,分析影响ID WG %的因素。用Cox模型分析患者的年龄、性别、血白蛋白水平、IDWG %与患者生存预后的关系 ,并比较不同IDWG %分组之间死亡原因的差别。结果 患者总体的 5年存活率为 5 2 .1% ,不同IDWG %分组之间存活率分别为 31.9%和 5 7.3% ,有显著差异 (P =0 .0 0 2 )。在Cox分析中 ,患者的年龄、性别、血白蛋白水平、IDWG %均被接纳进入模型 ,低IDWG %的相对危险度为 1.34。两组的死亡原因差别无显著性差异。结论 患者的存活率与水摄入量有关 ,高的水摄入量水平伴随低的死亡风险 ,并且这一关系独立于患者年龄。

Objective To study the relationship between interdialytic weight gain(IDWG%) and patients survival. Methods A retrospective study was performed with 144 stable hemodialysis patients treated in our center during 1995 and 2003. Patients were divided into two groups, group A (IDWG%≤6%) and group B (IDWG%>6%). Life table and Cox's proportional hazard model were used to determine the hazard factors. Results For the entire study cohort, the mean IDWG% was 5.83%. Five-year survival rate was poorer in group A (31.9% vs. 57.3%, P=0.002). IDWG% was enrolled in Cox model even after adjusting the effects of patient's age, gender and serum albumin level. The relative risk was 1.34 (P=0.003). Conclusions IDWG% is a hazard factor to hemodialysis patients, a greater IDWG% is associated with a better prognosis. This relationship is valid even after the adjustment of patient's age, gender and serum albumin level.