糖尿病终末期肾病血液透析患者危险因素的初步分析

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几种危险因素。方法选择34例ESDN血液透析患者和同期透析的46例非糖尿病终末期肾病(Non-ESDN)血液透析患者,回顾分析死亡率、死亡原因、并发症、营养状态及血生化改变。结果ESDN组1年死亡率、3年死亡率分别为17.6%和38.2%,3年死亡率明显高于Non-ESDN组(P<0.01),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(94.1%);两组营养状态评估(SGA)均差,但ESDN组的血浆白蛋白明显低于Non-ESDN组。结论ESDN患者并发症发生率及死亡率均比Non-ESDN高,积极治疗并发症、改善营养状态是提高患者生存率的关键。

Objective To investigate the risk factors which might influence the survival rate of the end- stage diabetic nephropathy （ESDN） patients treated with hemodialysis. Methods 34 ESDN patients were analyzed retrospectively for the causes of death, mortality, complications, nutritional status and blood biochemical parameters. 36 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 years of group ESDN were 17.6% and 38.2%. The causes of death were cardiovascular diseases and infection diseases. Cardiovascular diseases were the major complications accounting for 94. 1%. The nutritional status were 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 patients treated with hemodialysis is higher than that of non- ESDN patients. More complications occur in ESDN patients. Preventive treatment for the complications and improvement of nutritional status are the key strategy to enllance survival rate.