中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (03): 171-175.doi: 10.3969/j.issn.1671-4091.2021.03.006

• 临床研究 • 上一篇    下一篇

合并2 型糖尿病腹膜透析患者的转归及影响因素的单中心回顾性分析

高洪志1,罗健华1,陈万佳1,张璐芸1,李交1,胡聃2,邓跃毅1   

  1. 1上海中医药大学附属龙华医院肾内科 2上海中医药大学附属第七人民医院肾内科
  • 收稿日期:2020-08-13 修回日期:2020-12-16 出版日期:2021-03-12 发布日期:2021-03-12
  • 通讯作者: 罗健华 luojianhua301@126.com E-mail:15121037047@163.com
  • 基金资助:
    上海市青年科技英才扬帆计划资助(20YF1449700)；上海中医药大学附属龙华医院龙医学者 (育苗计划：LYTD-85)

The outcome and its influencing factors of peritoneal dialysis patients with type 2 diabetes mellitus

  1. 1Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; 2Department of Nephrology, Shanghai the Seventh People's Hospital, Shanghai 200137, China
  • Received:2020-08-13 Revised:2020-12-16 Online:2021-03-12 Published:2021-03-12

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摘要： 【摘要】目的探讨合并2 型糖尿病患者的开展腹膜透析的结局和危险因素。方法选取2015 年5月至2020 年5 月间在上海中医药大学附属龙华医院肾内科开展腹膜透析时已确诊2 型糖尿病的患者，收集病例资料和结局信息，分析筛选出现终点事件即退出腹膜透析的危险因素。结果最终共筛选纳入研究对象113 例，其中男性70 例(61.95%)，女性43 例(38.05%)，中位年龄60(54,68)岁,中位透析随访时长27(15,48)月。共47 例(41.59%)发生了定义的终点事件，其中死亡17 例(15.04%)，转血液透析30 例(26.55%)。经单因素筛选和多因素COX 分析显示，肥胖(HR=2.131,95% CI:1.123～4.045, P=0.021)是影响PD 病人生存的独立危险因素。113 例患者中位腹膜透析时间为50(25,123)月；肥胖患者中位透析时间42(20, 71)月，相较于非肥胖病例的中位透析时间85(34, 123)月显著减少(c2= 5.750, P=0.016)；晚透析患者中位透析时间73(33,120)月，相较于非晚透析患者中位透析时间41(20,58)月，差异有统计学意义(c2= 4.501, P=0.034)。结论肥胖的合并2 型糖尿病患者开展腹膜透析的退出风险相对较高。

关键词: 腹膜透析2 型糖尿病, 回顾性研究, 转归, 危险因素

Abstract: 【Abstract】Objective To evaluate the outcome and its influence factors of peritoneal dialysis (PD) patients complicated with type 2 diabetes mellitus. Methods The PD patients diagnosed with type 2 diabetes at the beginning of PD and treated in our center from May 1, 2015 to May 1, 2020 were enrolled in this study. Their clinical data and outcome information were collected. The end-point events were analyzed and the influence factors for the withdrawal of PD were then identified. Results A total of 113 eligible subjects were recruited, including 70 males (61.95%) and 43 females (38.05%) with an average age of 60 (54, 68) years old and an average PD period of 27 (15, 48) months. Defined end events that led to the withdrawal of PD developed in 47 patients (41.59%), of which 17 cases (15.4%) died and 30 cases (26.55%) transferred to hemodialysis. Univariate and multivariate COX analyses showed that obesity (HR=2.131, 95% CI:1.123～4.045, P=0.021) and the time of starting PD (HR=1.863, 95% CI: 0.872～3.243, P=0.055) were the independent risk factors for survival of the PD patients. In the survival analysis, the median PD duration was 50 (25, 123) months in the 113 patients; the median PD duration was 42 (20, 71) months in obese patients, significantly shorter than that of 85 (34, 123) months in non-obese patients (c2=5.750, P=0.016). The median PD duration was 73 (33, 120) months in late dialysis patients, significantly longer than that of 41 (20, 58) months in nonlate dialysis patients (c2= 4.501, P=0.034). Conclusion Obese PD patients with type 2 diabetes have a relatively high risk of withdrawal from PD.

Key words: Peritoneal dialysis, Type 2 diabetes mellitus, Retrospective study, Outcome, Risk factor

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