摘要
目的:回顾性研究湖南省终末期肾脏疾病(end stage renal disease,ESRD)血液透析患者原发疾病构成及其相关因素如年龄、性别、透析转归和死亡原因。方法:收集1997年1月至2004年12月中南大学湘雅二医院ESRD血液透析患者1285例,湖南省人民医院ESRD血液透析患者95例,株洲市一医院ESRD血液透析患者112例,南华大学附属第二医院及衡阳市中心医院ESRD血液透析患者130例,累计1622例,分析其原发疾病构成、年龄、性别、透析治疗持续时间、转归和死亡原因。结果:ESRD血液透析患者平均年龄(46.91±15.41)岁,男女之比为1.45∶1。最主要的原发疾病为慢性肾小球肾炎,占56.43%;其次为高血压肾病,占12.58%;梗阻性肾病占9.13%;糖尿病肾病占8.85%。近年来糖尿病肾病呈上升趋势。ESRD血液透析持续超过3个月的维持性血液透析患者共581例,其中43.7%的患者仍在进行维持性血液透析治疗,血液透析时间最长者为13年,13.0%患者已行肾脏移植,19.9%转至外院治疗,7.2%改为腹膜透析,1.4%因经济困难放弃治疗,14.8%死亡。ESRD维持性血液透析患者1年生存率为93.53%,3年生存率为68.92%,5年生存率62.51%。主要死亡原因为心血管事件,占53.6%;其次为脑血管意外,占21.0%。结论:本组患者以中、老年为主,男性多见;ESRD血液透析患者主要原发疾病为慢性肾小球肾炎,近年来,糖尿病肾病的构成比呈上升趋势;ESRD维持性血液透析患者1年生存率93.53%,3年生存率为68.92%,5年生存率62.51%;主要死亡原因为心血管事件,其次为脑血管意外。
Objective To analyze the etiology and the relevant factors such as age, sex, blood pressure, outcomes and causes of death in end stage renal disease （ ESRD ） with hemodialysis （ HD ） in some hospitals in Hunan province. Methods The retrospective analysis included 1 622 ESRD with HD patients. Data on the etiology, demographic and epidemiologic aspects of these patients were examined, and life expectancy and mortality rate were calculated. Results In 1 622 ESRD with HD patients, the average age at the start of HD was 46.91 ± 15.41 , and the male/female ratio was 1.45/1. As the leading cause, chronic glomerulonephritis accounted for 56.43% , followed by hypertensive nephropathy （ 12.58 % ） , obstructive nephropathy （ 9. 13 % ） and diabetic nephropathy （8.85%）. In recent years, the constituent ratio of diabetic nephropathy rose. The number of ESRD maintenance HD （MHD） patients was 581. Among them, 43. 7% remained MHD, 13. 0% received renal transplantation, 19.9 % were transferred to other hospitals for HD, 7.2 % became peritoneal dialysis, 14.8 % died, and 1.4 % ceased treament for economic reasons. The longest MHD was 13 years. The 1 st-year, 3 rd-year and 5 th-year survial rate of MHD patients was 93.53% , 68.92% and 62. 51%, respectively. The leading cause of death was cardiovascular incidence （53.6%）, and then cerebrovascular disorder （21.0% ）. Conclusion In this group of ESRD with HD patients, the age of starting dialysis was 30 - 70. The first cause was chronic glomerulonephritis. As the age increased, the constituent ratio of diabetic nephropathy rose. In MHD patients , the lst-year ,3rd-year and 5th-year survial rate of maintenance hemodialysis patients was 93. 53% , 68.92 % and 62.51% , respectively . The first cause of death was cardiovascular accidence, and then cerebrovascular disorder.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2006年第3期400-403,共4页
Journal of Central South University ：Medical Science
基金
湖南省卫生厅课题(B2005-038)
