影响维持性血液透析患者预后相关因素的生存分析_专家库

胡晓舟主治医师 医院：郑州大学第五附属医院科室：肾病风湿科

影响维持性血液透析患者预后相关因素的生存分析

胡晓舟王少亭张瑾卢永申张燕杨宏

（全文发表在《中华全科医师杂志》,2011,10（5）:348-350）

http://www.cqvip.com/main/detail.aspx?id=37743615郑州大学第五附属医院肾内科胡晓舟

【摘要】目的 研究影响维持性血液透析患者生存率的相关危险因素、生存率及其影响因素。方法收集2005年1月至2010年1月住院的维持性血液透析透析患者121例。采用kaplan-meirie分析和cox比例风险模型分析透析前各临床指标对患者生存率的影响。结果平均随访28.9个月，1年、3年及5年总体生存率分别为93.0%、66.5%、45.8%。死亡率为24.0%。经kaplan-meirie分析发现透析年龄（χ²=12.214，p=0.001）、透析次数（χ²=8.369，p=0.004）和心血管疾病（χ²=6.582，p=0.010）与预后最密切。经多变量cox回归分析发现，透析次数、心血管疾病、透析年龄、营养状况为影响生存率的独立因素(rr分别为3.116、2.974、2.675、2.355)。结论透析充分性、心血管疾病、开始透析年龄及营养状况为影响生存率主要因素，值得临床工作中加以重视。

【关键词】维持性血液透析；临床流行病学；生存率

survival analysis of prognostic associated factors in the maintenance hemodialysis patients hu xiao-zhou, wang shao-ting, zhang jin，lu yong-shen,zhang yan，yang hong. department of nephrology，the fifth affiliated hospital of zhengzhou university，450052，china

【abstract】 objective to analyze the probably risk factors that influences the survival of maintenance hemodialysis (mhd) patients. methods demographic characteristics,clinical data and causes of disease were investigated from jan 1, 2005 to jan 1, 2010. 121 cases were enrolled this retrospective study. survival probability was studied with kaplan-meier method and clinical prognostic factors were analyzed with the cox regression analysis. results the median follow-up duration was 28.9 months. the1, 3, 5 year survival rate was 93.0%,66.5%,45.8% respectively and the mortality was 24.0%. by kaplan-meirie analysis, age of dialysis (χ²=12.214, p=0.001), dialysis frequency (χ²=8.369, p=0.004) and cardiovascular disease (χ²=6.582, p=0.010) related close to prognosis. cox regression analysis showed dialysis frequency, cardiovascular disease, age of dialysis and nutritional status were independent prognostic factors (relative risk was 3.116, 2.974, 2.675, 2.355 respectively). conclusion the main causes of death in long term survived patients were dialysis adequacy, cardiovascular disease, age of dialysis and nutritional status, which was attached much weight in the clinical work.