维持性血液透析患者恶性肿瘤的发生情况分析

Incidence of malignant tumor in patients with maintenance dialysis

目的探讨维持性血液透析患者的恶性肿瘤发生情况、临床特点及可能相关因素。方法选择1993年1月至2013年6月期间行血液透析患者共657例,调查其恶性肿瘤的发生情况及临床特点,并行logistic回归分析影响肿瘤发生的危险因素。结果 657例血液透析患者中23例发生了恶性肿瘤,占血液透析患者的3.5%。其中男性15例(65%),女性8例(35%)。发现肿瘤的平均年龄为(67.56±8.06)岁,发现肿瘤的平均透析龄为(71.05±51.66)个月。肺癌例数最多(39.1%),其次是肾癌(21.7%)。logistic回归分析结果显示:年龄、血红蛋白、白蛋白是肿瘤发生的独立危险因素。结论维持性血液透析患者恶性肿瘤发病率明显高于正常人,年龄、血红蛋白、白蛋白是恶性肿瘤的独立危险因素。

Objective To evaluate the incidence of malignancies and its related factors in patients on maintenance hemodialysis. Methods We recruited 657 maintenance hemodialysis patients from January1993 to June 2013 in a cross-sectional study to investigate the incidence of malignant tumors and the clinical features of the malignancies. The related factors were analyzed with logistic regression. Results Among657 patients,23 cases（ 3. 5%） developed malignant tumors,including 15 males（ 65%） and 8 females（ 35%）. The mean age of at the time of cancer diagnosis was（ 67. 56 ±8. 06） yr. The mean time from the start of dialysis to the diagnosis of cancer was（ 71. 05 ± 51. 66） months. The most common cancer site was the lung（ 39. 1%） followed by the urinary tract and pancreas. Logistic regression analysis showed that age,hemoglobin level and albumin level were the independent risk factors of developing cancers. Conclusion The incidence of malignant tumor was significantly higher in maintenance dialysis patients than that in the general population. Age,hemoglobin level and albumin level are the risk factors.