维持性血液透析患者预后的五年随访研究

Five- year Follow- up Study of Prognosis of Maintenance Hemodialysis Patients

目的探讨维持性血液透析(MHD)患者死亡的危险因素。方法采用前瞻性队列研究方法,收集2006年12月—2007年1月在我院规律血液透析的患者53例,随访至2012-01-31,记录死亡时间和死亡原因,应用Cox回归分析死亡的预测因素。结果在60个月的随访中,共死亡26例,1、3、5年的累计存活率分别为90.6%、64.2%、50.9%。Cox回归分析结果显示年龄、血清清蛋白和C反应蛋白是MHD患者全因死亡的独立危险因素(HR值分别为3.310、0.416、3.296),C反应蛋白是MHD患者心血管死亡的独立危险因素(HR值为4.269)。结论年龄和C反应蛋白是本研究人群死亡的危险性因素,而血清清蛋白是死亡的保护性因素。

Objective To investigate the mortality-related risk factors in maintenance hemodialysis （MHD） patients.Methods A prospective cohort study was followed-up among the 53 stable hemodialysis patients treated in our center during December,2006 and January,2007 until 31 January 2012.By using Cox proportional analysis the predictors for death were examined according to the data about postmortem interval and cause of death recorded in the study.Results During the 60 -month follow-up,a total of 26 patients died.Cumulative survival rates of 1,3 and 5 years were 90.6％、64.2％、50.9％respectively.Cox proportional hazards analysis showed that age,ALB and CRP were the independent risk factors for all-cause mortality （HR =3.310; 0.416; 3.296） and CRP was the independent risk factor for cardiovascular mortality in MHD patients （HR =4.269）.Conclusion In MHD patients,age and CRP were independent risk factors for death,while ALB was protective factor.