上海市静安区行血液透析治疗的终末期肾病患者流行病学调查

发布时间：2018-05-26 22:45

  本文选题：终末期肾病 + 血液透析　； 参考：《上海医学》2015年01期

【摘要】：目的回顾性调查上海市静安区行血液透析治疗的终末期肾病(ESRD)患者的流行病学特征。方法收集2011年1月—2013年12月在上海市静安区中心医院血液透析室行血液透析治疗的ESRD患者224例,分析其性别、年龄、原发病构成、不同透析持续时间患者的转归、死亡原因分布、医疗保险模式、主观营养状况评估(SGA)和生活质量的简单评估(包括工作状态、生活自理能力和每年住院次数)。结果上海市静安区行血液透析治疗ESRD患者的男女之比为1.41∶1,平均年龄为(66.5±16.1)岁,其中60~79岁者占49.1%。原发病构成中慢性肾炎占第1位(35.3%),其次为糖尿病肾病(26.3%)和高血压肾病(21.0%)。近3年新增加的行血液透析治疗ESRD患者中,糖尿病肾病与慢性肾炎同居第1位(均占30.2%),其次为高血压肾病(19.8%),但三者间构成比的差异无统计学意义(P=0.642)。224例行血液透析治疗的ESRD患者的血液透析持续时间均≥3个月,仍在上海市静安区中心医院继续行血液透析者占43.8%,死亡患者占32.6%,转上海其他医院者占16.5%,肾移植者占1.3%。其中,透析3个月~1年的患者最多(59例),病死率(42.4%)也最高(P值均0.05)。各种死亡原因中≥60岁患者的构成比均显著高于60岁患者(P值均0.05)。糖尿病肾病患者总体病死率最高(37.0%,27/73),其次为慢性肾炎(24.7%,18/73)和高血压肾病患者(23.3%,17/73,P值均0.05)。死亡原因以脑血管卒中、心血管事件和肺部感染为主。医疗保险模式以重大疾病医疗保险为主(占80.4%),其次为外地报销(占12.9%)。≥60岁患者的轻-中度营养不良和重度营养不良发生率均显著高于60岁患者(P值均0.05)。生活质量评估中,不能自理和自理但依赖家人分别占37.9%和22.3%;住院次数0~1次/年94例(42.0%),2~5次/年69例(30.8%),≥6次/年61例(27.2%)。结论上海市静安区行血液透析治疗的ESRD患者以老年患者居多,新增糖尿病肾病病例数增长速度最快,尽管以重大疾病医疗保险为主,但患者的营养状况较差、并发症多、自理能力较差、住院次数较多、病死率较高。
[Abstract]:Objective to investigate the epidemiological characteristics of end-stage renal disease (ESRD) treated with hemodialysis in Jing'an District of Shanghai. Methods from January 2011 to December 2013, 224 ESRD patients who were treated with hemodialysis in the hemodialysis room of Central Hospital of Jing'an District, Shanghai, were collected and their sex, age, primary disease composition and outcome of patients with different duration of dialysis were analyzed. Distribution of causes of death, medical insurance model, subjective nutritional status assessment (SGA) and simple assessment of quality of life (including work status, self-care ability and number of hospitalizations per year). Results the male / female ratio of hemodialysis for ESRD patients in Jing'an District of Shanghai was 1.41: 1, with an average age of 66.5 卤16.1 years. Chronic glomerulonephritis was the first of the primary diseases, followed by diabetic nephropathy (26.3) and hypertension nephropathy (21.0). In the last three years, the newly added hemodialysis treatment for ESRD patients, Diabetic nephropathy and chronic glomerulonephritis cohabited in the first place (30.2%), followed by hypertension nephropathy (19.8%). However, there was no significant difference in the composition ratio between the three groups. The duration of hemodialysis was more than 3 months in ESRD patients who were treated with hemodialysis. 43.8patients were still undergoing hemodialysis, 32.6patients died, 16.5patients were transferred to other hospitals in Shanghai, and 1.3patients received kidney transplantation. Among them, there were 59 cases of hemodialysis from 3 months to 1 year, and the mortality rate was 42.4% (P = 0.05). The constituent ratio of patients aged 鈮，

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