血清白蛋白水平与维持性血液透析患者预后的关系

Relationship between serum albumin level and prognosis of maintenance hemodialysis patients

目的探讨血清白蛋白水平与维持性血液透析(MHD)患者预后的关系。方法选择MHD患者108例,按照血清白蛋白水平分为4组:白蛋白低水平组(<30 mg/dl)、白蛋白较低水平组(30～34 mg/dl)、白蛋白正常低限组(35～39 mg/dl)、白蛋白高水平组(>40 mg/dl)。采用COX回归分析血清白蛋白等因素对患者生存时间的影响。结果白蛋白高水平是预后的保护性因素,白蛋白低水平及年龄是预后的危险因素,白蛋白较低水平及白蛋白正常低限对患者预后无明显影响(P>0.05)。与存活患者相比,死亡患者高龄、合并心房纤颤、低血压的比例高。结论血清白蛋白水平与MHD患者病死率以及病情严重程度密切相关,低蛋白血症提示患者预后不佳,输注人血白蛋白制品对改善MHD患者的短期预后作用不明显。

Objective To study the relationships between serum albumin level and prognosis of maintenance hemodialysis patients（MHD）. Methods One hundred and eight maintenance hemodialysis patients were divided into 4 groups：low level of albumin group （ 〈 30 mg/dl） , relatively low level of albumin group （ 30 ~ 34 mg/dl） , notTnal level of albumin group （ 35 ~ 39 mg/dl） , and high level of albumin group（ 〉40 mg/dl） according to the level of serum albumin. The effect of serum albumin on survival time was analyzed by COX regression. Results High level of albumin was a protective factor for prognosis, ow level of albumin and age were the risk factors for prognosis, relatively low level of albumin or normal level of albumin had no significant effect on prognosis （P 〉 0.05）. Compared wittl survivors, non-survivors were older and had a higher proportion of complicating atrial fibrillation and hypertension. Conclusions Level of serum albumin is closely associated with both the severity and mortality of MHD. Hypoproteine- mia indicates unfavourable prognosis. Infusion of human blood albumin has no effect on significant improvement in short-term progno- sis in MHD.