中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (08): 411-414.doi: 10.3969/j.issn.1671-4091.2013.08.00

• 临床研究 • 上一篇    下一篇

血液透析患者透析龄分布规律方程的建立和验证

陈凤锟1,李冀军2   

  1. 1. 解放军总医院第一附属医院肾内科
    2. 解放军总医院第一附属医院 肾内科
  • 收稿日期:2013-04-07 修回日期:2013-05-09 出版日期:2013-08-12 发布日期:2013-08-12
  • 通讯作者: 李冀军lijj9536@sina.com E-mail:lijj9536@sina.com

The hemodialysis duration distributing equations: establishing and proving.

  • Received:2013-04-07 Revised:2013-05-09 Online:2013-08-12 Published:2013-08-12

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摘要： 目的　分析北京地区109家单位血透中心登记的2007、2008年度与透析龄相关的数据，了解透析龄分布规律，为透析质量评价提供新的初步的方法和思路。方法　依据两年度登记有透析龄的病例各5065、6506例，列出在透患者透析龄频数分布图，建立描述其特征的方程。并将在透患者与2008年度死亡患者的相应数据进行相关分析。结果　两年度透析龄频数分布图具有指数曲线的特征，透析龄与相应频数的构成比对数具有良好的线性相关，可拟合回归方程为lnCn=-1.54-0.30n和lnCn=-1.45-0.30n（n≥1）。对两方程归纳后能够采用统一拟合方程Cn=m×Ra-1 （n=0）和Cn=m×Rcn-1 （n≥1）描述不同年份的分布（其中m=[1/Ra+(1-Rcmax)/(1-Rc)]-1），两年度的实测数据与由方程描述的理论频数符合（χ2=5.63和11.61，P=0.58和0.11）。将2007、2008年度在透患者数据与2008年度死亡患者数据进行相关性分析，发现3组数据相互间相关系数r达到0.99、0.95和0.97（P<0.01）。结论　透析龄分布可使用方程描述；方程的系数Ra（急性下降率，即首年患者下降的比率）、Rc（慢性下降率，即首年以后的患者平均年下降率）的高低提示透析人群退出的相对快慢，可能是衡量透析单位治疗质量的一个新指标。此外，2007、2008两年度间、在透患者和死亡患者间透析龄分布存在一定联系，这为运用前一年度在透患者透析龄分布数据来推测后一年度在透患者和死亡患者的相应数据提供了线索。

关键词: 尿毒症, 肾透析, 时间因素, 流行病学

Abstract: Objective To analyze dialysis duration-related data registered by 109 HD (hemodialysis) units in Beijing in 2007 and 2008, understand distributing rules of dialysis duration, and provide new initial method and idea for HD quality evaluation. Methods Base on 5065 and 6506 cases whose dialysis duration were registered in these two years, the frequency distributing diagrams of prevalent HD patients’ dialysis duration were drawn and equations describing the characteristics of these diagrams were established. Then, correlation analysis were done among prevalent HD patients of the two years and died ones of 2008. Results Both of the frequency distributing diagrams of the two years had characteristics of exponential curves. Dialysis duration had good linear correlation with logarithm of proportion of corresponding cases’ frequency, and could be fitted by regression equations as lnCn=-1.54-0.30n and lnCn=-1.45-0.30n (n≥1). Through generalizing these equations, the unified equations as Cn=m×Ra-1 (n=0) or Cn=m×Rcn-1 (n≥1) could be used to describe distributions of different years (In which, m=[1/Ra+(1-Rcmax)/(1-Rc)]-1). The measured data of the two years matched very well with theoretical frequencies described by equations (χ2=5.63 and 11.61, P=0.58 and 0.11). If correlation analysis was done among data of prevalent HD patients in 2007 and 2008, and died ones in 2008, it could be found that correlation coefficients r of three groups were 0.99, 0.95 and 0.97 (P<0.01). Conclusion Distribution of dialysis duration can be described by equations. The coefficients of equations, such as Ra (acute decline rate, which is patients’ decline rate during the first year) and Rc (chronic decline rate, which is patients’ average decline rate during the years after the first year) prompt relative withdrawal speed of HD groups, so they might be new indicators to measure treatment quality of HD unit. Furthermore, distributions of dialysis duration have correlation between years of 2007 and 2008, or prevalent and died patients. So, a clue is provided for using recent data of prevalent HD patients to speculate corresponding data of prevalent and died HD ones of next year.

Key words: uremia, renal dialysis, time factors, epidemiology