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%）。
Objective To retrospectively investigate the epidemiological characteristics of end stage renal disease（ESRD）patients receiving hemodialysis in Jing＇an District of Shanghai.Methods Clinical data of224 ESRD patients who received hemodialysis in the Central Hospital of Jing＇an District in Shanghai between January 2011 and December 2013 were collected.Gender,age,primary disease,dialysis duration and clinical outcome,cause of death,medical insurance pattern,subjective global nutritional assessment（SGA）and simple assessment of quality of life（including work status,self-care ability and hospitalized time per year）were investigated.Results The ratio of male to female was 1.41∶1in the 224 hemodialysis patients,with an average age of（66.5±16.1）years and the largest portion of 60-79 years old（49.1%）.Chronic glomerulonephritis（35.3%）was the most common primary disease,followed by diabetic nephropathy（26.3%）and hypertensive nephropathy（21.0%）.In the latest three years,the growth rates of diabetic nephropathy,chronic glomerulonephritis and hypertensive nephropathy were 30.2%,30.2% and 19.8%;diabetic nephropathy was the one growing fastest in primary diseases,but there was no significant difference in the growth rates between the three primary diseases（P=0.642）.Among the 224 patients,the percentages of continuous dialysis,death,transferring to other hospital and renal transplant were 43.8%,32.6%,16.5% and 1.3%,respectively.The mortality rate in the patients aged over 60 years old was significantly higher than that in those aged less than 60 years old（P0.05）.The primary disease with the highest fatality（37%,27/73）was diabetic nephropathy,followed by chronic glomerulonephritis（24.7%,18/73）and hypertensive nephropathy（23.3%,17/73）.Cerebrovascular accident,cardiovascular event and lung infection were in the major of death.Serious illness health care was the most important medical insurance pattern（80.4%）,followed by the field reimbursement（12.9%）.Nutritional status
出处
《上海医学》
CAS
CSCD
北大核心
2015年第1期10-14,共5页
Shanghai Medical Journal
基金
上海市静安区卫生系统医学学科建设特色专科项目资助(JWXK201205)
关键词
终末期肾病
血液透析
流行病学
End stage renal disease
Hemodialysis
Epidemiology
