维持性血液透析患者与透析室距离远近对心血管并发症的影响

Effects of distance between residence and hemodialysis unit on cardiovascular complications and treatments of maintenance hemodialysis patients

目的了解贵阳市维持性血液透析（MHD）患者长期居住地与透析室距离远近对心血管行发症及疗效的影响。方法收集贵阳市12个血液透析中心MHD患者，以病历记载为依据，采集病例进行分布特征及统计学分析。结果2011年1月至2012年5月采集贵阳中12个血液透析中心5MHD患者其756例，男447例，女309例，男：女=1．45：1；平均年龄（49．1±14．7）岁。MHD患者心血管并发症496例（65．6％），经多因素Logistic回归分析，距离透析室远近为心血管并发症独立危险因素。距离最远（〉30km）患者Kt／V值、尿素下降率、每周透析频次和治疗时间均较其他3组低，该组患者血磷、甘油三酯、胆同醇显著高（均P〈0．05）。结论距离透析室远近为MHD患者心血管并发症独立危险因素，距离〉30km对透析充分性影响最大。

Objective To explore the effects of etiological classification and the distance between residenee and hemodialysis unit on cardiovascular complications and treatments in maintenance hemodialysis （MHD）patients. Methods A total of 756 MHD patients were collected from 12 hemodialysis centers of Guiyang, Cbina between January 2011 and May 2012. Their distribution characteristics and correlations were based on medical records. And statistical analyses were pertbrmed. Results The ratio of males and females was 1.45： 1. And their mean age was （49.1 ±14.7） years old. And 496（65.6%）cases suffered fi＇om cardiovascular complications. The analysis of multi-factor Logistic regression revealed that distance between residence and dialysis unit was an independent risk factor of cardiovascular complications. The group of the farthest distance （ 〉 30 km） had the worst influence on dialysis adequacy Kt/V score, urea clearance rate, dialysis frequency and time per week. And the levels of blood phospborus, triglyceride and cholesterol in the tburth group had marked elevations. It had a significant positive correlation with distance （P 〈 0. 05 ）. Conclusion The distance between residence and dialysis unit is an independent risk factor of cardiovascular complications in MHD patients. The farthest distance （ 〉 30 kin） has the greatest influence on dialysis adequacy.