中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (10): 736-740.doi: 10.3969/j.issn.1671-4091.2024.10.002

• 调查研究 • 上一篇    下一篇

中国血液透析患者心血管疾病负担的调查研究

王  琰    赵新菊    韦  洮   

  1. 100044 北京，1北京大学人民医院肾内科
    100191 北京，2中国医院协会血液净化中心分会
  • 收稿日期:2024-06-13 修回日期:2024-06-22 出版日期:2024-10-12 发布日期:2024-10-12
  • 通讯作者: 韦洮 E-mail:weitao63@163.com

Research on the burden of cardiovascular disease in hemodialysis patients in China

WANG Yan, ZHAO Xin-ju, WEI Tao   

  1. Department of  Nephrology, Peking University People's Hospital, Beijing 100044,China;  2Chinese Hospital Association Blood Purification Center Branch, Beijing 100191, China
  • Received:2024-06-13 Revised:2024-06-22 Online:2024-10-12 Published:2024-10-12
  • Contact: 100044 北京，1北京大学人民医院肾内科；100191 北京，2中国医院协会血液净化中心分会 E-mail:weitao63@163.com

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摘要： 目的  调查中国各血液透析(hemodialysis，HD)中心患者心血管疾病(cardiovascular disease，CVD)负担及疾病筛查情况，以明确各种CVD的患病率，分析目前HD患者CVD筛查及管理中存在的问题，为未来开展CVD相关的多中心研究提供理论依据。 方法  中国医院协会血液净化中心分会制定了关于HD患者心血管疾病筛查及负担的调查问卷，于2024年1月11日—18日通过问卷星对中国(不含港澳台地区)的HD中心的负责人进行问卷推送，调查CVD患病率及疾病筛查情况。 结果  共回收186份有效问卷，涵盖19个省、4个自治区和4个直辖市。冠心病和血管钙化是HD患者最常见的CVD类型，分别有55.9%和62.4%的HD中心患病人数比例超过40%；其次为缺血性脑卒中，心房颤动和脑出血的比例相对较低。68.6%的HD中心患者的年死亡率低于10%。在心血管疾病筛查方面：58.6%的HD中心每年为患者进行1次心脏彩色多普勒超声心动图检查，仅有25家(13.4%)每年为患者安排1次侧位腹平片，每年为患者进行1次脉搏波传导速度检查的HD中心只有15家(8.1%)，结果提示CVD筛查力度薄弱，血管钙化筛查最易被忽视。患者诊治依从性方面：39.8%的HD中心认为依从性一般或较差，83.3%的医务人员愿意参加CVD负担相关科学研究。 结论  本调查结果显示尽管我国HD患者合并CVD的比例较高，尤其是冠心病和血管钙化，但CVD评估方面，众多HD中心未能进行定期疾病筛查，尤其是血管钙化方面筛查最为薄弱，患者诊治依从性不佳。应进一步呼吁加强CVD疾病筛查与管理，对患者加强宣教，医患配合、早诊早治，共同降低HD患者CVD疾病负担。

关键词: 血液透析, 心血管疾病, 疾病负担

Abstract: Objective  The aim of this study was to investigate the burden of cardiovascular disease (CVD) in hemodialysis (HD) patients in China, so as to provide evidences for conducting a multicenter study on CVD in the future.  Methods  The HD Working Group of the HD Branch of the Chinese Hospital Association developed a questionnaire, and pushed the questionnaire through Questionnaire Star to the medical staff of HD centers in China from 2024.1.11-2024.1.18 to investigate the prevalence of CVDs and the screening status. Results A total of 186 valid questionnaires were collected, covering 19 provinces, 4 autonomous regions and 4 municipalities. Coronary artery disease and vascular calcification were the most common types of CVD in HD patients, with the proportion of prevalence exceeding 40% in 55.9% and 62.4% of HD centers, respectively; followed by ischemic stroke, with relatively low proportions of atrial fibrillation and cerebral hemorrhage. In 68.6% of HD centers, the annual mortality rate of patients was less than 10%. In terms of CVD screening, 58.6% of HD centers performed echocardiography for patients once a year, but only 25 (13.4%) arranged for lateral abdominal plain films for patients once a year, and only 15 (8.1%) HD centers performed pulse wave velocity for patients once a year. What’s more, 39.8% of HD centers considered patient compliance to be poor, and 83.3% of medical staff were willing to participate in studies related to the burden of CVD in HD patients.  Conclusion  The proportion of HD patients with CVD is high in China, especially coronary artery disease and vascular calcification, but numerous HD centers failed to conduct regular CVD screening, and patient compliance was poor. CVD screening and management should be strengthened in the future to reduce the burden of CVD disease in HD patients.

Key words: Hemodialysis, Cardiovascular disease, Disease burden

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