慢性肾功能衰竭患者死亡原因调查及其影响因素分析

Cause of death investigation and its influencing factors in patients with chronic renal failure

目的探讨慢性肾功能衰竭患者死亡原因及其影响因素。方法回顾性分析广东医学院附属石龙博爱医院2009年3月至2013年3月收治的73例慢性肾功能衰竭患者的临床资料,按患者是否死亡将所有患者分为死亡组(26例)与对照组(47例)。调查患者的死亡原因,并比较两组患者的临床资料,先进行单因素分析,再对单因素分析有意义的项目进行Logistic多因素回归分析以找出慢性肾功能衰竭患者死亡的影响因素。结果 26例患者中,5例死于心力衰竭,6例死于脑血管意外,6例死于严重感染,5例死于消化道出血,4例死于其他病因;单因素分析结果显示死亡组与对照组透析前年龄、血红蛋白、血清白蛋白、肾小球滤过率、血磷、平均动脉压比较差异有统计学意义(P<0.05);多因素分析结果显示透析前高龄、低肾小球滤过率及高血磷是慢性肾功能衰竭患者死亡的独立危险因素。结论具有高龄、低肾小球滤过率及高血磷临床特征的慢性肾功能不全患者的预后较差,对于此类患者应做好预防措施以改善预后。

Objective To analyze the death causes and influence factors in patients with chronic renal failure. Methods The clinical data of 73 chronic renal failure patients from March 2009 to March 2013 were retrospectively analyzed. According to whether the patients died, all patients were divided into death group （26 cases） and control group （47 cases）. Causes of death were inves- tigated, and the clinical data were compared between the two groups, given the single factor analysis, and then the meaningful pro- jects of the single factor analysis were taken multivariate Logistic regression analysis to find out the influence factors of death in pa- tients with chronic renal failure. Results Among the 26 patients, 5 cases died of heart failure, 6 cases died of cerebrovascular ac- cident, 6 cases died of severe infection, 5 cases died of gastrointestinal bleeding, 4 cases died of other causes ; Single factor analy- sis showed the differences of age, Hb, Alb, glomerular filtration rate, serum phosphorus, mean arterial pressure between the death group and the control group before dialysis were statistically significant （ P 〈 0. 05 ） ; Multivariate analysis showed the elderly, low glomerular filtration rate and high phosphorus before dialysis were independent risk factors for death in patients with chronic renal failure. Conclusion The elderly, patients with low glomerular filtration and clinical characteristics of hyperphosphatemia of chron- ic renal failure patients has poor prognosis, prevention measures should be made fbr such patients to improve the prognosis.