维持血液透析患者并发脑出血的临床分析

Clinical profiles of intracerebral hemorrhage in maintenance hemodialysis patients

目的探讨慢性肾功能衰竭维持血液透析合并脑出血的危险因素以及预后。方法回顾性分析我院45例慢性肾功能衰竭维持血液透析合并脑出血患者的临床资料,与30例无脑血管意外的慢性肾功能衰竭维持血液透析患者的临床指标进行比较。结果预测45例慢性肾功能衰竭患者并发脑出血危险因素的各种指标中,伴有高血压病、糖尿病、冠心病、充血性心力衰竭以及入院时升高的收缩压水平的比例与对照组比较差异有统计学意义(P<0.05)。应用Logistric回归分析显示伴有心律失常、透析时间长以及既往有脑卒中史的慢性肾功能衰竭维持血液透析患者预后差。结论维持血液透析并发脑出血患者的预后差;伴有高血压病、糖尿病、充血性心力衰竭、冠心病、心律失常、透析时间长以及既往有脑卒中史等指标可能是慢性肾功能衰竭维持血液透析患者促发脑出血的危险因素。

Objective To investigate the clinical profiles of intracerebral hemorrhage in chronic hemodialysis patients retrospectively, and emphasize on the factors affecting intracerebral hemorrhage. Methods We studied 45 chronic dialysis patients who were admitted to our hospital with a diagnosis of intracerebral hemorrhage retrospectively. The clinical characteristics of each individual were collected to compare with 30 patients who had chronic dialysis but did not intracerebral hemorrhage. Results Among the variables, hypertension, diabetes mellitus, coronary artery disease and congestive heart failure were more significant than the control group（ P 〈0.05）. Logistric regression showed there were poor outcome when patients had arrhythmia,long dialysis time and the history of stroke. Conclusion The patients with intracerebral hemorrhage in chronic hemodialysis had poor outcome. The variables including hypertension, diabetes mellitus, coronary artery disease, congestive heart failure, arrhythmia, long dialysis time and the history of stroke were markedly higher risks for hospitalized intracerebral hemorrhage in chronic dialysis patients.