中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (05): 289-292.doi: 10.3969/j.issn.1671-4091.2018.05.001

• 临床研究 •    下一篇

影响腹膜透析患者早期生存的因素分析

包文晗1,史春迎1,孙玲华1,孙庆华1,聂建东1,韩庆烽1,唐雯1   

  1. 1.  北京大学第三医院肾内科
  • 收稿日期:2018-01-18 修回日期:2018-02-06 出版日期:2018-05-12 发布日期:2018-05-12
  • 通讯作者: 唐雯 tanggwen@126.com E-mail:baowenhan_331@126.com
  • 基金资助:

    北京大学医信交叉基金(项目编号：BMU20160584)和中华医学会临床医学科研专项资金项目(14050460583)

Factors that affect the survival at early stage in patients on peritoneal dialysis

  • Received:2018-01-18 Revised:2018-02-06 Online:2018-05-12 Published:2018-05-12

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摘要： 【摘要】目的分析腹膜透析(peritoneal dialysis，PD)患者在1 年内的生存情况，及可能影响其预后的因素。方法回顾性分析2006 年6 月1 日～2013 年12 月31 日于北京大学第三医院开始PD 治疗的新患者的临床资料，采用Cox 回归模型分析影响患者1 年内死亡的危险因素。结果本研究共纳入患者608 例，其中1 年内死亡患者63 例，非死亡患者545 例，Cox 回归模型分析结果示：开始透析时高龄(HR 1.047，95% Cl 1.024～1.071，P＜0.001)，低白蛋白血症(HR 0.900，95% Cl 0.854～0.949，P＜0.001)，尿量少(HR 0.999，95% Cl 0.998～1.000，P=0.003)，卧床状态(HR 2.112，95% Cl 1.148～3.885，P=0.016)，有截肢病史(HR 10.927，95% CI 1.407～84.846，P=0.022)的患者1 年内死亡率高，而透析前在肾内科门诊规律就诊(HR 0.422，95% Cl 0.242～0.737，P=0.002)的患者死亡率低。结论透析前肾内科门诊规律就诊的PD 患者早期预后较好，而开始透析时高龄、卧床状态、有截肢病史、低白蛋白血症、尿量少的患者预后较差。

关键词: 腹膜透析, 早期生存, 影响因素

Abstract: 【Abstract】Objective To investigate the survival status within one year and the factors that affect the prognosis in patients on peritoneal dialysis (PD). Methods In this retrospective cohort study, patients who started PD during Jan. 1, 2006 to Dec. 31, 2014 were included. Cox regression model was used to estimate the factors that affect early survival of the patients. Results We recruited 608 patients, in which 63 patients died within one year and 545 patients rmained alive. Cox regression analysis showed that age (HR 1.047, 95% Cl 1.024～1.071, P＜0.001), hypoalbuminemia (HR 0.900, 95% Cl 0.854～0.949, P＜0.001), urine volume (HR 0.999, 95% Cl 0.998～1.000, P=0.003), bedridden (HR 2.112, 95% Cl 1.148-3.885, P=0.016) and amputation history (HR 10.927, 95% CI 1.407～84.846, P=0.022) were associated with higher mortality rate, and regular clinic visit pre-dialysis (HR 0.422, 95% Cl 0.242～0.737, P=0.002) was associated with lower mortality rate. Conclusions Regular clinic visit pre-dialysis was associated with better outcome. Patients with advanced age, bedridden status, amputation history, hypoalbuminemia and oliguria were associated with poor outcomes

Key words: Peritoneal dialysis, Early survival, Influence factors