吉林省维持性血液透析患者流行病学调查

发布时间：2018-05-19 01:28

  本文选题：维持性血液透析 + 数据库　； 参考：《吉林大学》2017年硕士论文

【摘要】：目的:全面了解中国吉林地区血液透析患者的流行病学特点。方法:以2014年-2016年吉林省血液透析病例信息登记系统数据(Chinese National Renal Data System,CNRDS)为研究对象,收集病例信息包括:人口学特征及年度变化、通路、诊断信息(包括原发病、传染病等)、实验室检验信息(包括:血红蛋白、血浆白蛋白、血钙、血磷、甲状旁腺激素等相关检查)、治疗信息(首次血液透析前治疗时间、血液透析治疗方案、透析充分性评估等)、预后转归(包括:转腹膜透析、肾移植、死亡、放弃治疗、失访等)。从而分析吉林省维持性血液透析(Maintenance hemodialysis MHD)患者基本流行病学特征及透析质量情况。结果:1.截至2016年12月31日吉林省9个地区共在CNRDS中登记患者数据的吉林省透析中心共146家,透析机2334台。CNRDS登记的吉林省MHD患者23470例,全省平均每年新增4186例MHD患者,增长率为26.66%。截至2016年12月31日,MHD患者每万人口点患病率为8.55%。2.2016年维持性血液透析患者平均年龄为(52.63±14.18)岁,男女比例为1.26:1。我省近3年MHD患者前3位原发病因依次为:原发性肾小球肾炎、糖尿病肾病、高血压肾损伤。我省血液透析仍以动静脉内瘘及永久性中心静脉置管为主,其中72.84%患者使用低分子肝素抗凝。我省近3年MHD患者掉队率平均为13.57%;转出患者中死亡患者所占比例最高,占31.2%;死亡患者平均年龄为(61.36±11.59)岁;死亡时平均透程为(84.90±67.25)月;各死亡原因中,心血管事件(占47.36%)是发生死亡的主要原因。3.我省MHD患者血红蛋白平均水平呈逐年增加趋势,大于等于110g/L患者比例逐年增加;我省MHD患者2016年和2014年白蛋白达标率明显高于2015年;在血钙、磷、PTH方面,达标患者的比例同样呈逐年上升趋势;近3年我省MHD患者平均KT/V为1.36,达标率逐年上升。结论:1.截至2016年12月31日吉林省9个地区共在CNRDS中登记患者数据的吉林省透析中心共146家,透析机2334台。血液透析登记患者23470例,每万人口点患病率为8.55例。2.2016年MHD患者平均年龄为(52.63±14.18)岁,首位原发病因为原发性肾小球肾炎。我省血液透析仍以动静脉内瘘及永久性中心静脉置管为主。心血管事件(47.36%)是发生死亡的主要原因。乙型病毒性肝炎为我省MHD患者中最常见的传染病。3.血液透析患者血红蛋白平均水平逐年增加,≥110g/L患者比例逐年增加;患者2016年和2014年白蛋白达标率明显高于2015年;血钙、磷、PTH水平达标患者的比例呈逐年上升趋势;目前我省主要选择KT/V作为其评价透析充分性指标,我省近3年维持性血液透析患者KT/V达标患者所占比例为35.24%、34.59%、34.21%,我省HD质量有待进一步提高。
[Abstract]:Objective: to investigate the epidemiological characteristics of hemodialysis patients in Jilin area of China. Methods: the data of Chinese National Renal Data system CNRDS from 2014 to 2016 in Jilin Province hemodialysis case registration system were used to collect case information, including demographic characteristics and annual changes, pathway, diagnostic information (including primary disease). Infectious diseases, laboratory testing information (including: hemoglobin, plasma albumin, blood calcium, blood phosphorus, parathyroid hormone, etc.), treatment information (first time before hemodialysis, hemodialysis treatment program, etc.) Dialysis adequacy assessment and prognosis (including peritoneal dialysis, kidney transplantation, death, abandonment of treatment, loss of visit, etc.) The basic epidemiological characteristics and dialysis quality of maintenance hemodialysis (HD) patients in Jilin Province were analyzed. The result is 1: 1. As of December 31, 2016, there are 146 dialysis centers in Jilin Province registered with CNRDS in 9 regions of Jilin Province, 23470 MHD patients registered in Jilin Province with 2334 dialysis machines. The average annual increase in the number of MHD patients in Jilin Province is 4186, with a growth rate of 26.66%. As of December 31, 2016, the prevalence rate of MHD patients per 10,000 population was 8.55 and 2.2016. The average age of maintenance hemodialysis patients was 52.63 卤14.18 years, and the ratio of male to female was 1.26: 1. The first three primary causes of MHD in recent 3 years were primary glomerulonephritis, diabetic nephropathy and hypertensive renal injury. In our province, arteriovenous fistula and permanent central venous catheterization were the main causes of hemodialysis, and 72.84% of the patients were treated with low molecular weight heparin (LMWH) anticoagulant. In recent three years, the average drop rate of MHD patients in our province was 13.57; the proportion of dead patients was the highest among the patients transferred out, accounting for 31.22.The average age of the dead patients was 61.36 卤11.59 years; the average dialytic course at the time of death was 84.90 卤67.25 months; among the causes of death, Cardiovascular events (47.36%) are the leading cause of death. The average hemoglobin level of MHD patients in our province is increasing year by year, and the proportion of patients more than equal to 110g/L is increasing year by year. The albumin reaching standard rate of MHD patients in 2016 and 2014 in our province is obviously higher than that in 2015. The average KT/V of MHD patients in recent three years was 1.36, and the rate of reaching the standard increased year by year. Conclusion 1. As of December 31, 2016, there are 146 dialysis centers and 2334 dialysis machines registered in CNRDS in 9 areas of Jilin Province. The average age of MHD patients in 2016 was 52.63 卤14.18 years old. The primary cause of primary glomerulonephritis was primary glomerulonephritis. Arteriovenous fistula and permanent central venous catheterization were still the main causes of hemodialysis in our province. Cardiovascular events (47.36) are the leading cause of death. Hepatitis B is the most common infectious disease in patients with MHD in our province. The average level of hemoglobin in hemodialysis patients increased year by year, the proportion of patients with 110g/L 鈮，

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