夜间血液透析患者退出原因及危险因素分析

发布时间：2018-03-06 23:11

本文选题：肾透析　切入点：夜间血液透析　出处：《第二军医大学学报》2017年08期 　论文类型：期刊论文

【摘要】：目的分析夜间血液透析(nocturnal hemodialysis,NHD)患者退出的原因并探讨其危险因素。方法收集第二军医大学长征医院2009年2月至2016年11月行NHD满3个月后退出NHD的47例患者和维持NHD的64例患者的临床资料,收集患者一般资料,比较两组患者首次行NHD及末次行NHD时的血红蛋白、血小板、白蛋白、铁蛋白、血钙、血磷、甲状旁腺激素等指标的差异,采用Cox回归模型分析患者退出NHD和死亡的危险因素。结果 47例患者退出NHD,行NHD的平均时间为(31.55±20.30)个月,退出原因分别是死亡、转院、转传统血液透析(CHD)、肾移植及其他。单因素Cox回归分析显示,在原发疾病中,高血压肾病(P=0.007,HR=2.913,95%CI:1.348~6.293)和糖尿病肾病(P=0.047,HR=2.401,95%CI:1.014~5.685)是NHD患者退出的危险因素,慢性肾炎综合征(P0.001,HR=0.095,95%CI:0.046~0.195)则是保护因素;在血液检测指标中,低白蛋白水平(P=0.007,HR=0.904,95%CI:0.840~0.973)是NHD患者退出的危险因素;高龄(P=0.027,HR=1.052,95%CI:1.006~1.101)是NHD患者退出的危险因素。多因素Cox回归分析显示,低白蛋白水平(P=0.007,HR=0.911,95%CI:0.848~0.991)是NHD患者死亡的独立危险因素。结论高血压肾病和糖尿病肾病是NHD患者退出的危险因素,慢性肾炎综合征是其保护因素。低白蛋白是NHD患者死亡的独立危险因素。
[Abstract]:Objective to analyze the causes of withdrawal of nocturnal hemodialysis patients with NHD at night and to explore its risk factors. Methods 47 patients with NHD who had been treated with NHD for 3 months from February 2009 to November 2016 and maintained NHD were collected from Changzheng Hospital, second military Medical University, from February 2009 to November 2016. Clinical data of 64 patients, To compare the difference of hemoglobin, platelet, albumin, ferritin, serum calcium, phosphorus and parathyroid hormone between the two groups during the first NHD and the last NHD. Cox regression model was used to analyze the risk factors of NHD withdrawal and death in 47 patients. Results the average time of NHD withdrawal was 31.55 卤20.30 months. The univariate Cox regression analysis showed that in the primary diseases, hypertension nephropathy was 2.913 ~ 95% CI: 1.348 ~ 6.293) and diabetic nephropathy was 2.401 ~ 95% CI 1.0145.685) were risk factors for the withdrawal of patients with NHD, and chronic nephritis syndrome (P 0.001) was 0.0959 ~ (5) CI 0.046 ~ (0.195). Among the blood test indexes, low albumin level (P0. 007 / HRN 0.904 / 95 CI: 0.840 / 0.973) is the risk factor for the withdrawal of NHD patients, while the elderly patients with P0. 027 / HR0. 052 / 95 CI: 1. 006 / 1.101) are the risk factors for the withdrawal of patients with NHD. The multivariate Cox regression analysis showed that. Low albumin level (P0. 007) is an independent risk factor for death in patients with NHD. Conclusion hypertensive nephropathy and diabetic nephropathy are risk factors for withdrawal of NHD patients. Chronic glomerulonephritis syndrome is the protective factor. Low albumin is an independent risk factor for death in patients with NHD.
【作者单位】：第二军医大学长征医院肾内科解放军肾脏病研究所;
【基金】：国家自然科学基金(81400687) Supported by National Natural Science Foundation of China(81400687)
【分类号】：R692.5

【相似文献】