中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (08): 562-565.doi: 10.3969/j.issn.1671-4091.2020.08.015

• 血液净化中心管理 • 上一篇    下一篇

武汉市血液透析死亡患者流行病学分析

闵永龙1,2,费世枝1,2,何达1,陈芳1,程力1,张燕敏1,2,熊飞1,2   

  1. 1武汉市第一医院肾病内科
    2武汉市血液透析质量控制中心 闵永龙、费世枝为共同第一作者
  • 收稿日期:2019-11-25 修回日期:2020-01-26 出版日期:2020-08-12 发布日期:2020-08-12
  • 通讯作者: 熊飞 xiongf23@sina.com E-mail:hydzym@sina.com
  • 基金资助:
    武汉市医学科研项目(WG18C01)

Epidemiological analysis of the death of maintenance hemodialysis patients inWuhan city#br#

  1.  1Department of Nephrology, The First Wuhan Hospital, Wuhan 430022, China;  2Wuhan Hemodialysis Quality Control Center, Wuhan 430022, China MIN Yong-long and FEI Shi-zhi contributed equally to this article Corresponding author: XIONG Fei, Email: xiongf23@sina.com
  • Received:2019-11-25 Revised:2020-01-26 Online:2020-08-12 Published:2020-08-12

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摘要： 【摘要】目的回顾性分析2015～2018 年武汉市维持性血液透析(maintenance hemodialysis，MHD)患者流行病学情况，为提高血液透析质量提供数据支持。方法以武汉市血液透析质量控制中心2015～2018 年登记的患者为研究对象，分析死亡患者的流行病学情况。结果① MHD 患者年度死亡率呈下降趋势(χ2=22.668，P＜0.001)，死亡患者的透析龄呈延长趋势(χ2=18.950，P＜0.001)；②透析1 年内死亡患者比例呈降低趋势(χ2=20.069，P＜0.001)。③死亡患者原发病以糖尿病占比最高(26.4%)，其次为高血压(25.1%)、原发性肾小球肾炎(22.1%)；④死亡原因依次为心血管事件(25.3%)、脑血管事件(15.8%)、感染(5.9%)、消化道出血(3.6%)。⑤中年组(45～59 岁)动静脉内瘘组(arteriovenous fistula, AVF)占比偏高，老年组(≥75 岁)AVF 占比最低(χ2=45.927, P＜0.001)。⑥通路为AVF 的患者中位生存时间40(65, 20)月，明显长于非AVF19(38, 9)月，且2 组患者生存曲线存在明显差异(χ2=104.818, P＜0.001)。结论武汉市MHD 患者年度死亡率呈下降趋势，死亡患者透析龄呈延长趋势，原发病以糖尿病为主，死亡原因以心血管事件为首，通路为AVF的患者生存时间相对更长。

关键词: 维持性血液透析, 死亡率, 流行病学

Abstract: 【Abstract】Objective To retrospectively analyze the epidemiology of maintenance hemodialysis (MHD) in Wuhan in the period from 2015 to 2018 in order to provide the supporting data for the improvement of quality control of hemodialysis. Methods Information of the MHD patients registered in the Quality Control System of Dialysis in Wuhan from 2015 to 2018 was retrospectively studied. Age, sex, dialysis age, primary disease, vascular access pathway and cause of death of the patients were analyzed. Results ①The decrease tendency of annual mortality was present in the MHD patients (χ2=22.668，P＜0.001), and
their dialysis age became longer (χ2=18.950, P＜0.001). ②Proportion of the MHD patients died in the first dialysis year became less (χ2=20.069, P＜0.001). ③Diabetes accounted for the highest proportion of primary diseases in death cases (26.4% ), followed by hypertension (25.1% ) and primary glomerulonephritis (22.1%). ④The cause of death was cardiovascular events (25.3%), cerebrovascular events (15.8%), infection (5.9%) and gastrointestinal bleeding (3.6%). ⑤The proportion ofAVF in the middlEaged group (45～59 years old) was significantly higher than that in other age groups, and the proportion ofAVF in the elderly group was the lowest (χ2=45.927, P＜0.001). ⑥ The median survival time ofAVF patients was 40 (65, 20) months, significantly longer than that of 19 (38,9) months in non-AVF patients (χ2=104.818, P＜0.001). Conclusion The annual mortality
rate of MHD patients inWuhan city was decreasing. In the death MHD patients, dialysis age became longer, the most important primary disease was diabetes, the most important cause of death was cardiovascular events, and the survival time was relatively longer inMHDpatients withAVF.

Key words: Maintenance hemodialysis, Mortality, Epidemiology

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