中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (02): 82-85.doi: 10.3969/j.issn.1671-4091.2013.02.00

• 临床研究 • 上一篇    下一篇

维持性血液透析患者住院原因及相关因素分析

张梅1,黄雯2,岳英3,孟秀云4   

  1. 1. 首都医科大学附属北京同仁医院;首都医科大学肾脏病学系
    2. 首都医科大学附属北京同仁医院肾内科
    3. 首都医科大学附属北京同仁医院
    4. 首都医科大学附属北京同仁医院肾内科血液透析中心
  • 收稿日期:2012-08-06 修回日期:2012-11-15 出版日期:2013-02-12 发布日期:2013-02-12
  • 通讯作者: 黄雯 huangw@trhos.com E-mail:huangw@trhos.com
  • 基金资助:
    中科级.863

Analyses of the cause of hospitalization and related risk factor in patients with maintenance hemodialysis

  • Received:2012-08-06 Revised:2012-11-15 Online:2013-02-12 Published:2013-02-12

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摘要： 摘要 目的 分析血液透析患者住院原因。方法：对2009年3月——2011年2月首都医科大学附属北京同仁医院99例长期维持性血液透析患者进行回顾性分析，观察住院患者的住院原因，比较住院和非住院患者的年龄、透析龄、收缩压、舒张压、血红蛋白、血糖、透析前血肌酐、透析前血钾、血浆白蛋白、透析前血钙、透析前血磷、全段甲状旁腺激素和透析充分性（KT/V值）等临床指标，利用多元逐步回归方法分析患者住院的相关危险因素。结果：24个月中，99例患者59人有住院记录；共计住院106例次，平均住院次数为1.07±1.22次；每次住院时间28.27±24.73天；住院的主要原因分别是心血管疾病、血管通路阻塞和肺部感染。住院组患者的年龄显著高于非住院组（66.6±12.62 vs.56.63±13.16,p=0.00）岁，住院组透析前血肌酐和血浆白蛋白显著低于非住院组（804.05±226.01 vs.954.80±226.35，p=0.03）μmol/L和 （33.13±4.16 vs.37.30±3.33，p=0.000）g/L。多元逐步回归分析结果发现，低透析龄和低蛋白血症是影响血液透析患者住院的相关危险因素（β=-0.03和-0.413）。结论：心血管系统疾病仍然是血液透析患者住院首要原因，血管通路阻塞和肺部感染是血液透析患者住院的重要原因。低蛋白血症和低透析龄是影响其住院的相关危险因素。

关键词: 血液透析, 住院, 危险因素

Abstract: [Abstract] Objective: To analysis the cause of hospitalization and related risk factor in patients with maintenance hemodialysis. Method: 99 hemodialysis patients were enrolled. Age, dialysis age, blood pressure, hemoglobin, blood glucose, serum creatinin, serum potassium, serum calcium, serum phosphorus, albumin, iPTH and KT/V were compared in hospitalization and non-hospitalization groups. The main cause and related risk factor for hospitalization were reviewed. Result: 59 out of 99 patients were hospitalized and they have 106 hospitalizations in observed period. Average hospitalization was 1.07±1.22 per patient and hospitalized days were 28.27±24.73 days per hospitalized patients. The main causes of hospitalization were cardiovascular disease, vascular access stenosis and pulmonary infection. Compare with non-hospitalization group, age of patient hospitalization group was older and the levels of albumin and serum creatinin were lower than those in MHD patients. （66.6±12.62 vs.56.63±13.16 years,p=0.00; 804.05±226.01 vs.954.80±226.35μmol/L，p=0.03; 33.13±4.16 vs.37.30±3.33 g/L，p=0.000）. Stepwise multivariate regression analysis showed hypoablbuminia and short dialysis age were risk factors to influence the hospitalization patients undergoing maintenance hemodialysis. Stepwise multivariate regression analysis showed hypoablbuminia and short dialysis age were risk factors to influence the hospitalization in patients undergoing maintenance hemodialysis. Conclusion: Cardiovascular disease, vascular access stenosis and pulmonary infection were the important causes for hospitalization in hemodialysis patient. Cardiovascular disease was the leading cause of hospitalization in patients with maintenance hemodialysis.

Key words: Hemodialysis, Hospitalization, Risk factor

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