中国血液净化

›› 2003, Vol. 2 ›› Issue (3): 139-141.

• 论著 • 上一篇    下一篇

血液透析治疗终末期肾病生存率及死因分析

张树新 伍 强 初 敏   

  1. 518033 深圳，广东省深圳市福田人民医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-03-19 发布日期:2003-03-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2003-03-19 Published:2003-03-19

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摘要： 目的 回顾性分析169例终末期肾病（ESRD）维持性血液透析（MHD）患者的生存率及死亡原因。方法 对2组不同年龄的169例MHD患者的年龄、性别、原发病对生存率的影响及死亡原因进行了比较分析。结果 发病患者群以中青年为主，发病平均年龄为（43.6±16.5）岁。男女之比为1.2∶1。发病原因中以慢性肾小球肾炎为主，为53%。继发性肾病中狼疮性肾炎占首位（11.8%）。其次为高血压肾病、糖尿病肾病及梗阻性肾病，分别为7.10%、7.60%和7.60%。2组不同年龄组生存率比较,中青年组5年、≥10年生存率分别为68.3%、52.4%。高龄组5年、≥10年生存率为45.0%，39.3%。高龄组生存率明显低于中青年组。不同病种对生存率比较,糖尿病肾病生存率最低，5年生存率为45.4%，无生存时间达到10年者。＞50岁患者死亡人数明显高于中青年组，死亡原因：脑血管意外为34.8%，心力衰竭17.4%，感染13.0%,心律失常13.0%，上消化道出血13.0%，肿瘤8.7%。结论 慢性肾小球肾炎是导致尿毒症的主要病因，生存率随年龄的增高而降低，糖尿病肾病是影响生存率的高危因素。本组MHD患者的死亡原因主要为脑血管意外和心力衰竭。

关键词: 血液透析, 生存率, 死亡原因

Abstract: Objective To analyse the survival rate and cause of death of the patients of end stage renal disease (ESRD)on maintenance hemodialysis(MHD). Methods 169 ESRD patients were enrolled in this retrospective study. The patients were divided into two groups according to age. The relationship between age, sex or primary diseases for ESRD and the survival rate or cause of death were analysed and compared. Results The average age was 43.6±16.5.sex ratio of male to female was 1.2∶1. Chronic glomerulonephritis was the major cause of ESRD, occupying 53%. Lupus nephritis occupied 11.8%, which was the most common cause among secondary nephropathy. Hypertensive, diabetic and obstructive nephropatly constituted 7.0%, 7.60 % and 7.60% respectively. The survival rate of the two groups divided by age was compared. The 5 year and 10 year survival rate of the young and middle age group were 68.3% and 52.4% respectively, while they were 45.0% and 39.3% for the elder age group The survival rate of the elder age group was significantly lower than that of the young and middle age group (P<0.05). Among the primary diseases of ESRD, diabetic nephropathy had the lowest survival rate. with a 5 year rate of 45.4%. and without 10 year survival. For the causes of death, cerebrovascular accidents constitued 10.1%, heart failure 7.7%, infection 6.5%, arrythmia 4.1%, upper gastrointestinal tract bleeding 4.1% and cancer 3.19%. Conclusion Chronicg lomerulonephritis was the major cause of ESRD. The survival rate decreased along with age. Diabetic nephropathy was a high risk factor for survival Cerebrovascular accident and heart failure were the major causes of death in this group.

Key words: Survival rate, Cause of death