2013年度河北省城乡新增血液透析患者的流行病学调查分析

Epidemiological survey of the new hemodialysis cases in urban and rural areas of Hebei province in 2013

目的分析2013年度河北省新增1771例血液透析患者的发病年龄、原发病因、地域分布等情况,探讨影响终末期肾脏病的危险因素,为终末期肾脏病的防治提供数据支持。方法对2013年1月1日～12月河北省所有开展血液净化治疗的医疗机构网上直报的血液透析患者的病例资料进行回顾性分析。各种相关数据的采集通过全国血液透析患者病例信息登记系统完成。结果 12013年度新增血液透析患者中农村人口为1032人,占58.27%;城市人口为739人,占41.73%。22013年度新增血液透析患者的年龄集中在45～64岁和20～44岁。农村、城市新增血液透析患者的年龄均集中在45～64岁和20～44岁,平均年龄分别为50.61±15.18岁vs.55.28±15.76岁（P〈0.01）。3 2013年度新增血液透析患者前3位的原发病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害。农村、城市新增血液透析患者前3位原发病因均依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害。42013年度新增血液透析患者所使用的血管通路中,临时中心静脉置管居于第1位,占60.19%,其次是自体动静脉内瘘占33.84%。农村新增血液透析患者临时中心静脉置管占65.80%,自体动静脉内瘘占28.32%。城市新增血液透析患者临时中心静脉置管占52.16%,自体动静脉内瘘占41.76%。结论慢性肾小球肾炎、糖尿病肾病、高血压肾损害是导致血液透析患者增加的主要原因。农村血液透析患者发病较早、原发病因以慢性肾小球肾炎为主、血管通路中以临时中心静脉置管为主。

Objective To analyze the differences in age,primary cause,and area distribution in the new hemodialysis cases from urban and rural areas of Hebei province in 2013,and to explore the risk factors of end stage renal disease（ESRD） for the build-up of its prevention strategies.Method The information about new hemodialysis cases in Hebei province from Jan.1,2013 to Dec.31,2013 was recruited and retrospectively analyzed.Data acquisition was performed from the National Hemodialysis Patient Information Registration System.Result 1 In the new hemodialysis cases in 2013,1032（58.27%） were from rural area,739（41.73%） from urban area;2 cases from rural area were significantly younger than those from urban area（50.61±15.18 y vs.55.28±15.76y;P〈0.01）;3 the most important primary cause of ESRD was chronic glomerulonephritis,followed by diabetic nephropathy and hypertensive nephrosclerosis;4at the beginning of hemodialysis,65.80% in rural cases and 52.16% in urban cases used temporary central venous catheter for vascular access,and 33.84% in rural cases and 41.76% in urban cases used arteriovenous fistula for blood access.Conclusion The main causes leading to hemodialysis in Hebei province were in the order of glomerulonephritis,diabetic nephropathy and hypertensive nephrosclerosis.The new hemodialysis cases were younger in rural area than in urban area.Temporary central venous catheter for vascular access was used more in rural ar-ea than in urban area.