维持性血液透析患者血尿酸水平和预后的关系

发布时间：2017-12-28 05:32

本文关键词：维持性血液透析患者血尿酸水平和预后的关系　出处：《浙江大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨维持性血液透析(MHD)患者血尿酸(SUA)水平和预后的关系。方法:纳入2010年1月1日至2014年12月31日期间,浙江省透析质量控制中心(ZDQM)新接收的诊断为终末期肾脏病(ESRD),维持性血透时间大于3个月的患者。通过构建Cox比例风险模型,分别从首次透析、透析3个月及透析12个月这3个时间点对SUA水平和预后的关系进行分析。结果:共纳入13270例患者,至随访终点,中位随访时间为868(502-1375)天,死亡患者为2560例,死亡率为19.3%。3个透析时间点的SUA水平与年龄均呈负相关(均P0.01),与血肌酐、血尿素氮、白蛋白、磷均呈正相关(均P0.05)。透析3个月时,高尿酸水平和低死亡相关(HR=0.99,P=0.03)。结论:MHD患者在透析3个月时,高尿酸可能是死亡的保护因素,但长远来看差异无统计学意义。这一结果需要通过前瞻性研究进一步证实。
[Abstract]:Objective: To investigate the relationship between the level of serum uric acid (SUA) and the prognosis in patients with maintenance hemodialysis (MHD). Methods: from January 1, 2010 to December 31, 2014, the Zhejiang dialysis quality control center (ZDQM) was newly diagnosed with end-stage renal disease (ESRD) and maintenance hemodialysis time was longer than 3 months. By constructing the Cox proportional hazard model, the relationship between the SUA level and the prognosis was analyzed from the first dialysis, 3 months of dialysis and 12 months of dialysis. Results: a total of 13270 patients were included, to the end point of follow-up, the median follow-up time was 868 (502-1375) days, and the death rate was 2560 cases, the mortality rate was 19.3%. The SUA level of 3 dialysis time points was negatively correlated with age (all P0.01), and was positively correlated with serum creatinine, blood urea nitrogen, albumin and phosphorus (all P0.05). At 3 months of dialysis, the high uric acid level was associated with low mortality (HR=0.99, P=0.03). Conclusion: high uric acid may be a protective factor for death in MHD patients at 3 months of dialysis, but there is no significant difference in the long term. This result needs to be further confirmed through prospective studies.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.5

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