摘要
目的探讨老年维持性血液透析患者的临床特征，为老年患者的血液透析治疗提供临床依据。方法选择2015年8月在暨南大学附属第一医院行维持性血液透析治疗的老年患者（≥65岁）50例作为观察组，设立同期血液透析中青年患者（〈65岁）47例作为对照组，比较2组患者的原发病、血管通路、透析充分性指标、营养状况相关指标以及透析并发症的发生率。结果观察组糖尿病肾病及高血压肾小动脉硬化所占比例高于对照组，但肾小球肾炎均为2组患者的首要病因，2组原发病构成差异有统计学意义（χ^2=21．332，P=0．003）。观察组透析龄4-204个月，平均（51．08±46．30）个月；对照组透析龄4-180个月，平均（45．43±40．43）个月，差异无统计学意义。观察组患者长期留置皮下隧道涤纶套导管使用率较对照组高，2组比较差异无统计学意义（χ^2=4．298，P=0．117）。血液透析前观察组血磷、血肌酐、尿酸、白蛋白低于对照组，2组比较差异有统计学意义（P〈0．05），2组血钙、全段甲状旁腺素、碱性磷酸酶、尿素氮、血红蛋白、C反应蛋白差异有统计学意义（P〉0．05）。观察组Kt／V为（1．54±0．27），对照组Kt／V为（1．59±0．29），2组比较差异无统计学意义（t=0．787，P=0．433）。观察组和对照组心胸比分别为（0．57±0．54）、（0．53±0．51），2组比较差异有统计学意义（t=2．215，P=0．029）。观察组患者透析并发症发生率（24％）高于对照组（8．5％），但2组比较，差异无统计学意义。结论糖尿病肾病、高血压肾小动脉硬化在老年血液透析患者中比例逐年增加，应引起重视。改善营养状况、保持血管通路长期通畅、个体化充分透析、防治各种并发症，有助于改善老年维持性血液透析患者的预后及生存率。
Objective To investigate the clinical features of elderly maintenance hemodialysis patients and provide the clinical basis for their hemodialysis treatment. Methods Fifty elderly maintenance hemodialysis patients （≥65 years old） as the observation group and 47 young maintenance he- modialysis patients（〈65 years old） as the control group from the First Affiliated Hospital of Jinan University in August 2015 were enrolled in this study. The clinical data of two groups were collected and analyzed, including primary diseases, vascular access, adequate dialysis index, nutritional status and the incidence of dialysis cofnplications. Results The incidence of diabetic nephropathy and hyper- tension renal arteriosclerosis in elderly hemodialysis group was higher than in young and middle-aged group. The glomerulonephritis was the primary cause of two groups of different ages in dialysis patients. There was no significant difference in primary disease constitution ratio between the two groups （χ^2 = 21. 332, P = 0. 003）. In elderly dialysis time was 4-204 months [mean （51.08 ±46. 30） months-1, and that in young and middle-aged group was 4- 180 months [mean （45.43 ± 40.43） months] with the difference being not statistically significant. More people chose to use long-term indwelling catheter cuff subcutaneous tunnel for elderly hemodialysis patients. There was no statistically significant difference between two groups （χ^2= 4. 298, P = 0. 117）. The levels of serum phosphorus, serum creatinine, uric acid, and albumin were lower in the elderly patients than in the young hemodialysis patients（P〈0. 05）. The levels of serum calcium, intact parathyroid hormone, alkaline phosphatase, urea nitrogen hemoglobin and C-reactive protein were not statistically significant between two groups（P〉0. 05）. Kt/V in elderly group and young group was（1.54 ± 0. 27） and （1.59 ± 0. 29） respectively with the difference being not significant（t = 0. 787, P = 0. 433）. The cardiothoracic ration in el
出处
《临床肾脏病杂志》
2016年第6期350-354,共5页
Journal Of Clinical Nephrology
基金
广东高校工程技术研究(开发)中心计划(NO.GCZX-A1104)
广东省社会发展领域科技计划项目(NO.2013B021400002)
广州市产学研协同创新重大专项申报书(民生科技研究)(NO.2014Y2-00510)
关键词
老年人
维持性血液透析
终末期肾脏病
The aged
Maintenance hemodialysis
End stage renal disease
