糖尿病肾病尿毒症患者危险因素分析

The risk factors in uremia patients with diabetic nephropathy

目的 探讨影响糖尿病肾病尿毒症血液透析患者的生活质量及长期存活的各种危险因素及防治方法。方法 观察 5 2例糖尿病肾病尿毒症患者和同期 5 8例非糖尿病肾病患者透析前后的血液生化指标、存活率、死亡原因及并发症。结果 糖尿病肾病组 1年和 2年存活率分别为 82 %和 71%。主要死亡原因是心血管病变 ,其次为感染。影响透析效果的主要并发症是心血管病变 ( 83 % )、高血压 ( 94% )、透析低血压 ( 3 5 % )、感染 ( 61% ) ,与非糖尿病肾病组比较有显著差异。结论 糖尿病肾病尿毒症患者较非糖尿病肾病患者应更早进行血透 ,肌酐清除率 <15ml/min即应透析 ,控制两次透析期间的体重增加 <5 % ,减少透析时血糖波动 ,防治并发症是减少危险因素 。

Objective: To investigate the risk factors that influence the quality of life and long-term survival of the ESRD patients caused by DN undergoing hemodialysis, and the prophylactic measures. Methods: Blood Biochemical index, survival rate, cause of death and major complication were observed in uremia patients with diabetic nephropathy (n=52) and without diabetic nephropathy (n=58) undergoing hemodialysis. Results: The survival rate of the patients with DN in the first and the second year were 82% and 71% respectively .The first cause of death was cardiovascular lesion, and the second was infection .The main complication influencing the effect of dialysis in patients with DN were cardiovascular lesion (83%), hypertension(94%), dialysis hypertension(35%), and infections(61%) .There were significant differences in these between the patients with DN and without DN. Conclusions: In order to decrease the risk factors and improve the quality of life and long-term survival rate of the ESRD patients cause by DN, it is very important to start hemodialisis when Creatinine clearance rate <15ml/min. The key points that decreasing risk factors and improving survival rate and quality of life were controlling the interdialysis weight gain within 5%, reducing fluctuation of blood sugar in dialysis.