北京市新增维持性血液透析患者的人口统计学及病因构成的变迁

Demographic trends in incident maintenance hemodialysis patients in Beijing

目的 分析北京市新增维持性血液透析（MHD）患者的人口统计学与病因构成及其变迁,为治疗策略的调整和制定提供依据.方法 回顾性分析北京市血液净化质量控制和改进中心数据登记系统2007～2012年间新增MHD患者的人口统计学及原发病资料,按照年份、性别、年龄等因素进行分层分析.结果 6年间新增MHD患者共14945例,患者中男性8397例,女性6548例,男：女1.3：1;其中登记年龄的13571例患者进入透析时的平均年龄为56.2＆#177;17.1岁,男性患者进入MHD平均年龄为54.4岁,女性为58.5岁.总体上,MHD患者的前5位原发病依次是是糖尿病、慢性肾小球肾炎（CGN）、高血压、间质性肾炎及多囊肾.糖尿病超过CGN,在男性患者这种转变发生于2009年,女性患者发生于2010年.新增MHD患者平均年龄缓慢增长,40岁以上中老年患者占新增MHD的主体（81.8％）.原发病构成比与年龄有关,对于＜50岁的患者,CGN占33.9％,为进入MHD的首位原因；50岁以上患者则为糖尿病,占31.6％.结论 新增MHD患者年龄呈缓慢增长趋势,40岁以上中老年患者为新进入MHD的主体.MHD患者存在性别差异,男性发病率高,进入MHD早.＜50岁患者进入MHD的首位病因是CGN; 50岁以上则为糖尿病；总体上糖尿病已经取代CGN成为北京市新增MHD患者的首位病因.

Objective To analyze the demographic trends and primary disease changes in incident main- tenance hemodialysis （MHD） patients in Beijing area. Methods We retrospectively review all the incident MHD patients registered in the Beijing Hemodialysis Quality Control and Improvement Center （BJHDQCIC） from 2007 to 2012. Their demographics and primary causes are investigated. Stratified analyses based on year, sex, age and other factors are conducted. Results There are totally 14,945 patents （8,397 males and 6, 548 females; males：females = 1.3：1）. The average age is 56.2＋17.1 years for the 13,571 patients whose ages were registered. The average age is 54.4 years for males and is 58.5 years for females. The top primary dis- ease for incident MHD patients is diabetes, followed by chronic glomerulonephritis （CGN）, hypertension, in- terstitial nephritis and polycystic kidney disease. The change from CGN to diabetes as the most common cause for MHD in male and female patients occurs in 2009 and 2010 respectively. The average age for inci- dent MHD patients is increasing. Older patients over 40 years of age account for 81.8% of the new MHD pa- tients. The constituent of primary diseases varies with age. CGN is the main cause and accounts for 33.9% in patients less than 50 years old, while diabetes is the leading cause and accounts for 31.6% in those over 50 years old. Conclusion The average age for incident MHD patients is gradually increasing. Older patients over 40 years of age account for the main body of new MHD patients. Males have higher MHD incidence and earlier age to enter MHD than females. The leading cause in MHD patients less than 50 years old is CGN, while that in patients more than 50 years old is diabetes. Diabetes has replaced CGN as the leading cause of in- cident MHD patients in Beijing area.