下肢动脉硬化闭塞症患者死亡危险因素分析

Risk Factors of Mortality of Patients with ASO

【目的】探讨影响下肢动脉硬化闭塞症（As0）患者死亡的相关危险因素。【方法】分析安徽医科大学第一附属医院2011年1月至2015年6月收治的235例As0患者的临床资料，根据随访结果将患者分为死亡组和生存组，对可能影响患者死亡的相关因素如治疗方式、缺血程度分级、血液学指标及合并症进行统计分析，对有统计学意义的影响因素进行COX多因素分析。【结果】235例患者随访获得有效病例186例，死亡组患者年龄〉70岁、严重下肢缺血（CLI）、心脏疾病、慢性肾功能不全、脑血管疾病、贫血、低蛋白血症、保守治疗的比例均显著高于生存组，差异均具有统计学意义（均P〈0．05）。CLI、低白蛋白血症、心脏疾病和保守治疗是影响患者死亡的独立危险因素（均P〈0．05）。【结论】CLI、低白蛋白血症、心脏疾病和保守治疗是影响AS0患者死亡的独立危险因素，临床工作中需注意纠正ASO患者营养不良、贫血、低蛋白血症等，对基础合并症需对症治疗。

[Objective] To analyze the factors influencing the mortality of patients with lower limbs arteriosclerosis obliterans （ASO）. [Methods] The clinical data of 235 patients with ASO from January 2011 to June 2015 from our hospital were retrospectively collected. According to follow-up results, patients were divided into two groups i.e. survival and death. Methods of treatment, classification of ischemia, hematology indices, and complications which may affect the prognosis were analyzed. [Results] Only 186 patients out of the original 235 patients completed their follow-up; 58 patients died and the mortality rate was 31%. In the death group, the percentages of aging （more than 70 years old）, criti cal limb ischemia （CLI）, heart disease, cerebrovascular disease, chronic renal insufficiency, anemia, hypoalbuminemia, conservative treatment were higher than those of the survival group （significant differences with p〈0.05）. Further statis- tical results showed that CLI, hypoalbuminemia, heart disease, and conservative therapy method were independent risk factors of the mortality of ASO patients. [Conclusion] CLI, hypoalbuminemia, heart disease, and conservative therapy were independent risk factors of the mortality of ASO patients. Therefore it is very important to deal with these indicators properly in patients with ASO.