摘要
目的:调查2011年～2016年四川省血液透析患者年病死率、死亡原因等情况,为提高透析患者生存率及持续血液透析质量控制改进提供相关数据。方法:回顾性分析2011年～2016年四川省301家血液透析中心网上直报的43 818例血液透析患者及8 285例死亡患者的相关资料,按年度、年龄、原发疾病等因素对死亡患者进行分层分析。相关数据收集通过全国血液净化病例登记系统完成。结果:(1)2011年～2016年四川省血液透析患者年病死率为11.3%,9.1%,7.3%,6.9%,6.9%,5.8%。(2)不同原发疾病的年病死率:糖尿病>高血压>慢性肾小球肾炎;(2)死因依次为心血管事件(24.48%)、猝死(21.83%)、脑血管事件(21.72%)。(3)心血管事件占死因比例呈下降趋势,而脑血管事件呈上升趋势。(4)老年组(≥60岁)占总死亡人数的61.53%,原发病因以糖尿病为主(32.49%),死因以心血管事件为主(19.56%);青中年组(<60岁)原发病因以慢性肾小球肾炎为主(51.98%),死因以脑血管事件为主(21.89%)。结论:2011年～2016年四川省血液透析患者年病死率从11.3%降至5.8%,心血管事件占死因比例呈下降趋势,脑血管事件呈上升趋势,提示关注血液透析患者心血管疾病的同时,还需关注脑血管疾病,尤其是老年糖尿病患者。
Objective： To investigate the mortality and causes of death in maintenance hemodialysis（ MHD）patients in Sichuan province from Jan 2011 to December 2016. Methodology： We retrospectively analyze the data of43818 hemodialysis patients and 8 285 deaths reported by 301 dialysis centers in Sichuan via Chinese National Renal Data System（ CNRDS） from 2011 to 2016.Stratified analyses of death patients based on year,age,primary disease were conducted.Results：（1） The annual mortality of MHD patients in Sichuan province from 2011 to 2016 was 11. 3%,9. 1%,7. 3%,6. 9%,6. 9%,5. 8% respectively. The mortality according to primary disease from high to low were diabetes,hypertension and glomerulonephritis.（ 2） The main causes of death were cardiovascular events（ 24. 48%）,sudden death（ 21. 83%）,cerebrovascular events（ 21. 72%）.（ 3） The deaths due to cardiovascular events wasdecresing,while cerebrovascular events and sudden death were rising.（ 4） Most of the death cases were in elderly patients（ ≥60 years of age,61. 53%）. Diabetic nephropathy was frequently found in elderly group（ 32. 49%）,and the main cause of death is cardiovascular events（19. 56%）. Glomerulonephritis was the most frequently primary disease in middle age group（60 years of age,51. 98%）.Their main cause of death was cerebrovascular events（ 21. 89%）. Conclusion：The annual mortality of MHD patients in Sichuan province from 2011 to 2016 were 11. 3% ～ 5. 8%. The deaths due to cardiovascular events was decreasing,while cerebrovascular events was rising which indicated when we focused on management of cardiovascular disease in hemodialysis patients.We should also pay attention to the risk of cerebrovascular disease,especially elderly diabetic patients.
作者
邹杨
洪大情
蒲蕾
吴姝焜
何强
李贵森
ZOU Yang;HONG Daqing;PU Lei;WU Shukun;HE Qiang;LI Guisen(Department of Nephrology, Sichuan Academy of Medical Sciences ＆ Sichuan Provincial People＇s Hospital, Chengdu 610072, China)
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2018年第3期225-228,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
基金
中国医院协会课题(CHABP2016-12)
