儋州地区维持性血液透析患者的死亡率及其影响因素分析

Mortality of patients undergoing maintenance hemodialysis in Danzhou area and its influencing factors.

目的了解儋州地区维持性血液透析(MHD)患者的死亡率及其影响因素,为MHD的防治提供依据。方法回顾性分析2014年1月至2019年12月儋州市人民医院收治的346例MHD患者的临床资料,根据死亡的情况分为死亡组(n=72)和非死亡组(n=274)。应用单因素及多因素Logistic回归方法分析MHD患者发生死亡的独立危险因素。结果346例MHD患者的死亡率为20.8%,死亡原因以心血管疾病、感染性疾病及脑血管疾病多见,分别占36.1%、23.6%、18.1%;单因素分析结果显示,死亡组患者的首次透析年龄、首次血管通路、合并心脑血管疾病、合并感染性疾病、血红蛋白(Hb)、红细胞体积分布宽度(RDW)、白蛋白(ALB)及C反应蛋白(CRP)水平与非死亡组比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,首次透析年龄大、合并心脑血管疾病、合并感染性疾病、Hb<85 g/L、RDW≥16%、ALB<32 g/L及CRP≥12 mg/L是影响MHD患者发生死亡的独立危险因素(P<0.05)。结论儋州地区MHD患者的死亡率较高,影响MHD患者发生死亡的危险因素较多,需采取相关措施以降低MHD患者的死亡风险。

Objective To investigate the mortality rate of patients undergoing maintenance hemodialysis(MHD)in Danzhou area and its influencing factors,so as to provide basis for the prevention and treatment of MHD.Methods The clinical data of 346 MHD patients admitted to Danzhou People's Hospital from January 2014 to December 2019 were retrospectively analyzed.According to their mortality,they were divided into a dead group(n=72)and a non-dead group(n=274).Univariate and multivariate logistic regression were used to analyze the independent risk factors of death in MHD patients.Results The mortality rate of 346 MHD patients was 20.8%,and the causes of death were mostly cardiovascular diseases,infectious diseases,and cerebrovascular diseases,accounting for 36.1%,23.6%,and 18.1%,respectively.Univariate analysis showed that age of first dialysis,first vascular access,complication with cardiovascular and cerebrovascular diseases,complication with infectious diseases,hemoglobin(HB),red blood cell volume distribution width(RDW),albumin(ALB),and C-reactive protein(CRP)levels in the death group showed statistically significant differences as compared with those in the non-death group(P<0.05).Multivariate logistic regression analysis showed that older age of the first dialysis,complication with cardiovascular and cerebrovascular diseases,complicated with infectious diseases,Hb<85 g/L,RDW≥16%,ALB<32 g/L,and CRP≥12 mg/L were independent risk factors of death in MHD patients(P<0.05).Conclusion The mortality of MHD patients in Danzhou area is high,and there are many risk factors affecting the death of MHD patients.Therefore,relevant measures should be taken to reduce the death risk of MHD patients.