老年维持性血液透析患者死亡原因分析

Analysis on Causes of Death in Elderly Maintenance Hemodialysis Patients

目的:分析老年维持性血液透析(maintenance hemodialysis,MHD)患者主要死亡原因及C-反应蛋白(C-reactive protein,CRP)、血浆白蛋白(serum albumin,ALB)变化情况。方法:本研究纳入2009年8月至2012年6月在我院死亡,且60岁以上老年MHD患者21例[其中男性14例,女性7例。平均年龄(70.17±10.05岁)],回顾分析其一般资料及死亡前3个月、6个月CRP、ALB水平及随机选取同期非死亡老年MHD患者20例(男12例,女8例,平均年龄68.61±11.42岁)调查其相应化验指标并做对比分析。结果:心、脑血管病为第一位死因,感染性疾患占第二位。多数患者透析生存年限小于5年。死亡患者CRP水平高于非死亡患者[15.75±4.74VS 7.64±4.87),P<0.05],ALB低于非死亡患者[(37.65±7.91 VS 35.89±4.39),P<0.05]。结论:老年MHD患者死亡率较高,存在慢性炎症状态及营养不良。

Objectives：To investigate the causes of death in elderly maintenance hemodialysis（MHD） patients. And to analyse the variation of the concentration of C-reactive protein（CRP） and serum albumin（ALB） in those patients.Methods：There were 21 patients [14 men, 7 women ,mean age （70.17±10.05）]recruited in this study. They died in our Blood purification Center from Aug 2009 to Jun 2012.And we chose 20 patients [12 men,8 women,mean age （68.61±11.42）]randomly as the control group treated at the same period. We compared the concentration of CRP and ALB at the time of 3 and 6 month before they died, and compared these items between the two groups.Results：Cardiocerebral vascular disease are the top 1 cause to the death of MHD patients. Infection disease was next it. Most people died in five years after dialysis treatment. The concentration of CRP in death group was higher than that in control group（15.75±4.74 VS 7.64±4.87,P〈0.05）. And the ALB concentration was just the reverse（37.65±7.91 VS 35.89±4.39,P〈0.05）.Conclusion：The death rate was high in elderly MHD patients.Chronic inflammation and malnutrition were prevalent in these patients.