糖尿病肾病血液透析患者发生并发症及死亡的危险因素分析

Analysis of Risk Factors of Complications and Death in Hemodialysis Patients with Diabetic Nephropathy

目的分析糖尿病肾病血液透析患者发生并发症及死亡情况,并探讨其相关影响因素。方法研究对象在2012年9月至2016年1月我院收治的200例糖尿病肾病血液透析患者,其中有89例患者出现并发症或死亡。测定所有患者的年龄、性别、BMI、住院时间、平均脉动压、血红蛋白、血清清蛋白、CRP、e GFR、透析间期体质量增加值,分析上述指标与糖尿病肾病血液透析患者发生并发症及死亡的相关性。结果单因素分析显示,年龄、糖尿病肾病病程、住院时间、血红蛋白、透析间期体质量增加值是糖尿病肾病血液透析患者并发症及死亡的影响因素(P<0.05),而性别、BMI、血清清蛋白、CRP、e GFR对LADA糖尿病肾病血液透析患者并发症及死亡无显著性影响(P>0.05);经多元Logistic回归分析,住院时间≥29(OR:2.857)、血红蛋白≥96.30(OR:2.131)、透析间期体质量增加值≥2.65(OR:2.174)、年龄≥56(OR:2.036)是糖尿病肾病血液透析患者患者并发症及死亡的危险因素,其危险程度依次降低。结论随着年龄增加、住院时间延长、血红蛋白水平升高和透析间期体质量增加值增加,糖尿病肾病血液透析患者发生并发症及死亡的概率也将大大提高。建议糖尿病肾病血液透析患者针对上述危险因素积极进行干预性防护,避免和预防并发症及死亡发生。

Objective To analyze the complications and death of hemodialysis patients with diabetic nephropathy,and to explore its influencing factors.Methods 200 patients with diabetic nephropathy were enrolled in our hospital from September 2002 to January 2016,of which 89 patients had complications or died.All the patients′ age,gender,BMI,duration of hospitalization,the average systolic pressure,hemoglobin,serum albumin,CRP,e GFR,mean interdialysis weight gain was determined.The correlation between the above indexes and complications and mortality in patients with diabetic nephropathy.Results Univariate analysis showed that age,duration of hospitalization,diabetic nephropathy,hemoglobin,mean interdialysis weight gain factors in hemodialysis patients with diabetic nephropathy complications and death effect（P〈0.05）,while gender,BMI,serum albumin,CRP,e GFR,LADA in patients with diabetic nephropathy undergoing hemodialysis complications and no death significant effect（P〈0.05）;by multivariate Logistic regression analysis showed that hospitalization time=29（OR：2.857）,aged 96.30（OR：2.131）,the mean interdialysis weight gain is more than 2.65（OR：2.174）,aged 56（OR：2.036）is in hemodialysis patients with diabetic nephropathy in patients with complications and the risk of death the degree of risk factors,in order to reduce.Conclusion With the increase of age,prolonged hospitalization time,hemoglobin level and mean interdialysis weight gain increases,the probability of complications and death will greatly improve hemodialysis in patients with diabetic nephropathy.It is suggested that patients with diabetic nephropathy should be actively intervened to prevent the occurrence of complications and death.