腹膜透析患者生存状况及危险因素研究

Survival status and risk factors for continuous ambulatory peritoneal dialysis patients

目的了解腹膜透析患者生存状况,探讨影响腹膜透析患者长期生存的因素。方法回顾性分析2010年6月1日-2014年5月31日在中南大学湘雅二医院腹膜透析中心植入腹透管并开始腹透的338例患者的临床资料,采用Kaplan-Meier法计算患者生存率,绘制生存曲线,利用多因素COX回归模型计算风险比值,了解影响腹膜透析患者生存率的危险因素。结果截止2015年12月31日,继续腹透235例(69.5%),转肾移植18例(5.3%),转血透32例(9.5%),死亡42例(12.4%),失访11例(3.3%)。腹膜透析患者半年生存率为92.9%,1年生存率86.3%,2年生存率76.5%,3年生存率73.6%,5年生存率70.4%。血清白蛋白、残余肾功能、腹膜感染是影响腹膜透析患者生存的危险因素(P<0.05)。结论中南大学湘雅二医院腹膜透析中心腹膜透析患者早期生存率与国内报道水平相近,5年生存率较高。血清白蛋白、残余肾功能、腹膜感染是影响腹膜透析患者生存的主要危险因素。

Objective To evaluate the survival rate of the patients having continuous peritoneal dialysis and to explore the associated factors for survival rate. Methods The clinical data of 338 cases who started to have continuous ambulatory peritoneal dialysis （CAPD） at the Second Xiangya Hospital from June 2010 to May 2014 were retrospectively analyzed. Kaplan-Meier method was used to calculate the patients＆#39; survival rate. Cox regression model was used to define the prognosis risk factors. Results By the end of December 31, 2015, 235 patients had continuous peritoneal dialysis （69.5%）, 18 had kidney transplantion （5.3%）, 32 turned to have hemodialysis （9.5%）, 42 died （12.4%）, 11 were lost to follow-up （3.3%）. The 6-month, l-year, 2-year, 3-year and 5-year survival rate was 92.9%, 86.3%, 76.5%, 73.6% and 70.4% respectively. The risk factors for the survival of peritoneal dialysis patients were serum albumin, residual renal function （RRF） and peritoneal infection （P〈0.05）. Conclusions The early survival rate of the patients receiving continuous peritoneal dialysis in the Second Xiangya Hospital is similar to those in the domestic reports, but the 5-year survival rate is higher. Serum albumin, RRF and peritoneal infection are the main risk factors for survival of the peritoneal dialysis patients.