糖尿病肾病血液透析患者发生肺炎的相关因素分析

Analysis of the related factors of pneumonia in patients with diabetic nephropathy

目的 :对糖尿病肾病血液透析患者发生肺炎的相关因素进行探讨,为临床治疗和干预提供理论依据。方法 :选取2010年6月至2015年6月期间于我院血液透析中心进行透析的300例患者作为研究对象。根据患者有无合并糖尿病肾病分为糖尿病肾病组和非糖尿病肾病组。对2组患者肺炎发生情况进行分析,探讨糖尿病肾病血液透析患者发生肺炎的相关因素。结果 :1.糖尿病肾病组患者年龄大,高血压(76%)、脑卒中(32%)发病率明显高于非糖尿病肾病组(63.6%、2.8%),差异具有统计学意义;2.糖尿病肾病组患者BMI更高,舒张压、平均动脉压、血清白蛋白较低,在BMI、eGFR、舒张压、平均动脉压、血清白蛋白等指标方面与非糖尿病肾病组患者相比,差异具有统计学意义;3.共有20例(6.7%)患者发生肺炎,其中糖尿病肾病组有6例,非糖尿病肾病组14例,2组之间差异具有统计学意义。4.多因素COX回归分析高BMI及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素。结论 :高BMI及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素,对于接受血液透析治疗的糖尿病肾病患者应注意控制体重,预防发生营养不良。

Objective To explore the related factors of pneumonia in patients with diabetic nephropathy hemodialysis, Pro-vide theoretical basis for clinical treatment and intervention. Method From June 2010 to June 2015, 300 patients with hemo-dialysis in our hospital were selected as the research object. According to the patients with diabetic nephropathy, diabetic ne-phropathy is divided into diabetic nephropathy group and non diabetic nephropathy group. The occurrence of pneumonia in the 2 groups was analyzed, To explore the related factors of pneumonia in patients with diabetic nephropathy hemodialysis. Result 1 diabetic nephropathy patients with age, hypertension (76%), stroke (32%) were significantly higher than those in non diabetic nephropathy group (63.6%, 2.8%), The difference was statistically significant; 2 patients with diabetic nephropathy group were higher in BMI, diastolic blood pressure, mean arterial pressure, lower serum albu min, In BMI, eGFR, diastolic blood pressure, mean arterial blood pressure, serum albu min and other indicators compared with non diabetic nephropathy group, The differ-ence was statistically significant; 20 a total of 3 patients (6.7%) had pneumonia, The diabetic nephropathy group had 6 cases, Non diabetic nephropathy group, 14 cases, The difference between the 2 groups was statistically significant. 4 multivariate COX regression analysis of high BMI and low serum albu min were independent risk factors for the occurrence of pneumonia in pa-tients with diabetic nephropathy. Conclusion high BMI and low serum albu min are independent risk factors for the occurrence of pneumonia in patients with diabetic nephropathy, For diabetic nephropathy treated with hemodialysis, we should pay atten-tion to control weight, Prevention of malnutrition.