影响糖尿病终末期肾病血液透析患者长期生存率的危险因素分析

The risk factors analysis for end-stage diabetic nephropathy patients treated with hemodialysis

目的探讨影响糖尿病终末期肾病(ESDN)血液透析患者长期生存率的危险因素,以提高ESDN血液透析患者的长期生存率。方法31例ESDN血液透析患者和同期透析的42例非糖尿病终末期肾病(non-ESDN)血液透析患者相比较,回顾性分析了死亡率、死亡原因、并发症、营养状态及血生化改变。结果ESDN组1、3年死亡率分别为19.3%和41.9%,3年死亡率明显高于non-ESDN组。主要死因为心血管病变(47.4%)和感染性疾病(26.3%)。主要并发症是心血管病变(94%)。两组营养状态评估(SGA)均差,但ESDN组的血浆清蛋白明显低于non-ESDN组。结论ESDN组并发症发生率及死亡率均比non-ESDN组高。积极治疗并发症,改善营养状态是提高生存率的关键。

Objective To investigate the risk factors which might influence the survival rate of the end-stage diabetic nephropathy （ESDN） patients treated with hemodialysis. Methods Thirty -one ESDN patients were analyzed retrospectively for the causes of death, mortality, complications, nutritional status and blood biochemical parameters. Forty-tow non-ESDN patients treated with hemodialysis with the same age at the same period were selected as control. Results The mortality for 1 year and 3 year of group ESDN were 19.3% and 41.9%. The causes of death were cardiovascular di-seases and infection diseases. Cardiovascular diseases was the major complication accounting for 94.0%. The nutritional status was poor in both groups, but the serum albumin level of group ESDN was lower than that of group non-ESDN, Conclusion The mortality of ESDN treated with hemodialysis patients is higher than that of non-ESDN group. More complications were observed in ESDN group. Preventive treatment for the complications and improvement of nutritional status are the key strategy to enhance survival rate.