维持性血液透析并发脑出血患者临床特征分析

Analysis of Clinical Characteristics of Cerebral Hemorrhage in Maintenance Hemodialysis Patients

【目的】探讨维持性血液透析患者并发脑出血的临床特点及相关危险因素。【方法】对比分析27例维持性血液透析并发脑出血患者和35例维持性血液透析无脑出血患者的临床资料并作统计学分析。【结果】脑出血组伴有高血压病、糖尿病、冠心病、充血性心力衰竭者以及高血压水平、使用普通肝素的比例与对照组比较差异有统计学意义（P〈0．05）；两组在年龄、性别、肝肾功能等方面相比较均无显著差异；脑出血组低密度脂蛋白胆固醇（LDL-C）和血红蛋白（HB）与对照组比较有统计学显著差异（P〈0．05）；脑出血组的病死率明显高于对照组（33．3％和8．6％，P〈0．01）。【结论】维持性血液透析患者并发脑出血是多因素作用的结果。积极控制血压、选用恰当的抗凝方法，积极治疗并发症有着重要的临床意义。

[Objective]To explore the clinical characteristics and related risk factors of cerebral hemorrhage in maintenance hemodialysis patients. [Methods]The clinical data of 27 maintenance hemodialysis patients with cerebral hemorrhage and 35 maintenance hemodialysis patients without cerebral hemorrhage were compared and analyzed statistically. [Results]There was significant difference in the proportion of hypertension, diabetes mellitus, coronary artery disease, congestive heart failure, hypertension level and the usage of common heparin between cerebral hemorrhage group and control group（ P 〈0.05）. There was no significant difference in age, sex, hepatic and renal function between two groups. There was significant difference in low density lipoprotein cholesterol（LDL-C） and hemoglobin（HB） between cerebral hemorrhage group and control group（ P d0.05）. The mortality of cerebral hemorrhage group was obviously higher than that in control group（33.3% vs 8.6%, P 〈0.01）. [Conclusion]The cerebral hemorrhage in maintenance hemodialysis patients is caused by multiple factors. Active controlling of blood pressure, the selection of the appropriate anticoagulant method and active treatment has important clinical significance.