摘要
目的了解海南地区315例维持性血液透析(MHD)患者的死亡情况及其危险因素,为MHD的防治提供依据。方法回顾性分析2017年1月至2019年12月海南地区行MHD患者315例,根据其死亡的情况分为死亡组(65例)和非死亡组(250例)。应用单因素及多因素logistic回归分析影响MHD患者死亡的独立危险因素。建立风险预测模型,应用受试者工作特征(ROC)曲线判断该模型对MHD患者死亡的预测能力。结果315例MHD患者的病死率为20.6%(65/315),死亡原因以心血管疾病、感染性疾病及脑血管疾病多见,分别占35.4%(23/65)、24.6%(16/65)、16.9%(11/65)。单因素分析显示,死亡组的合并心脑血管疾病、合并感染性疾病、血红蛋白、血磷、白蛋白低于非死亡组,而首次透析年龄和C反应蛋白水平高于非死亡组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,首次透析年龄大(OR=2.240,95%CI:1.638~5.237)、合并心脑血管疾病(OR=4.225,95%CI:3.106~9.805)、合并感染性疾病(OR=3.106,95%CI:2.115~7.284)、血红蛋白<90 g/L(OR=2.703,95%CI:1.924~7.283)、血磷<1.10 mmol/L(OR=1.692,95%CI:1.205~3.882)、白蛋白<30 g/L(OR=3.928,95%CI:2.406~8.738)及C反应蛋白>10 mg/L(OR=2.417,95%CI:1.835~6.783)是影响MHD患者发生死亡的独立危险因素(P<0.05)。MHD患者死亡风险预测模型的ROC曲线下面积为0.914(95%CI:0.858~0.975,P<0.05)。结论MHD患者的病死率仍较高,影响MHD患者死亡的危险因素较多,应积极采取有效措施,以提高患者的生存率。
Objective To investigate the mortality and risk factors of 315 patients with maintenance hemodialysis(MHD)in Hainan,and to provide evidence for the prevention and treatment of MHD.Methods From January 2017 to December 2019,clinical data of 315 MHD patients in Hainan were retrospectively analyzed,and according to their mortality,they were divided into dead group(65 cases)and non-dead group(250 cases).Univariate and multivariate logistic regression were used to analyze the independent risk factors of death in MHD patients.The area under receiver operating characteristic(ROC)curve was used to determine the ability of the model to predict the death of MHD patients.Results The mortality rate of 315 MHD patients was 20.6%(65/315),and the causes of death were mostly cardiovascular diseases,infectious diseases and cerebrovascular diseases,accounting for 35.4%(23/65),24.6%(16/65)and 16.9%(11/65),respectively.Univariate analysis showed that the age of first dialysis,combined cardiovascular and cerebrovascular diseases,combined infectious diseases,hemoglobin,blood phosphorus,albumin and C-reactive protein levels in the death group were higher than those in the non-death group(all P<0.05).Multivariate logistic regression analysis showed that older age of the first dialysis(OR=2.240,95%CI:1.638-5.237),complicated with cardiovascular and cerebrovascular diseases(OR=4.225,95%CI:3.106-9.805),complicated with infectious diseases(OR=3.106,95%CI:2.115-7.284),hemoglobin<90 g/L(OR=2.703,95%CI:1.924-7.283),blood phosphorus<1.10 mmol/L(OR=1.692,95%CI:1.205-3.882),albumin<30 g/L(OR=3.928,95%CI:2.406-8.738)and C-reactive protein>10 mg/L(OR=2.417,95%CI:1.835-6.783)were independent risk factors of death in MHD patients(P<0.05).Conclusions The mortality of MHD patients is still high,and there are many risk factors affecting the death of MHD patients.Therefore,effective measures should be taken to improve the survival rate of MHD patients.
作者
欧月秀
温莉玲
李国娇
邢月珠
李玲
莫世松
Ou Yuexiu;Wen Liling;Li Guojiao;Xing Yuezhu;Li Ling;Mo Shisong(Department of Nephrology,Hainan Aishen Nephrosis Hospital,Haikou 571700,China;Department of Nephrology,Sanya Central Hospital,Sanya 572000,China)
出处
《国际泌尿系统杂志》
2022年第2期334-337,共4页
International Journal of Urology and Nephrology
关键词
肾透析
海南
死亡原因
Renal Dialysis
HAINAN
Cause of Death
作者简介
通信作者:莫世松,Email:13876911821@163.com。
