摘要
目的观察血磷变异程度对终末期肾病血液透析患者生存状况的影响。方法选取2010年6月—2015年6月大连大学附属中山医院肾内科进行血液透析的终末期肾病患者180例作为研究对象,搜集患者的临床资料、检测指标以及临床预后资料根据患者血液透析结果,按照血磷变异系数(CV)的中位数将患者分为高变异组95例(CV≥0.226 mmol/L)和低变异组85例(CV<0.226 mmol/L)。分析血磷变异对终末期肾病血液透析患者预后的影响。结果 180例患者全因死亡43例(23.9%),因心血管病死亡24例(13.3%),高变异组患者的全因病死率28.4%(27/95)高于低变异组18.8%(16/85)(χ~2=2.071,P=0.027)。Logistic回归分析发现,老龄、血磷变异度高、低血清白蛋白是血液透析患者全因死亡的独立危险因素(OR=0.082,95%CI 1.712~4.467;OR=0.323,95%CI1.022~2.137;OR=0.372,95%CI 1.621~13.721)。结论终末期肾病血液透析血磷高变异组患者的全因死亡和心血管死亡的风险明显高于血磷低变异组患者。
Objective To explore the effect of variation of serum phosphorus on hemodialysis patients with end stage of renal disease （ESRD）.Methods One hundred and eighty patients with end stage of renal disease who underwent hemodialysis in our hospital from June 2010 to June 2015 were selected and clinical data were collected.According to the results of hemodialysis,the patients were divided into high variant group and low variant group according to the median CV of blood phosphorus variation,CV ≥ 0.226 mmol/L was high variant group,CV 〈 0.226 mmol/L was low variant group.The effect of CV level on patients with hemodialysis was analyzed.Kaplan Meier method was used to analyze the survival rate and log rank method was used to test significance.Cox proportional hazards model was used to analyze the key factors of death.Results The mean age of the patients was （66.51±11.34） years old,39 patients （21.7%） died due to cardiovascular death,21 patients （11.7%） died of cardiovascular disease,the all-cause mortality 28.4%（27/95） was higher than that in the low variant group 18.8%（16/85） （P〈0.05）.Cox regression analysis found that aging,high and low variability of blood phosphorus and serum albumin in hemodialysis patients is due to the independent risk factors of death （OR=0.082,95%CI 1.712-4.467;OR=0.323,95%CI 1.022-2.137;OR=0.372,95%CI 1.621-13.721）.The survival rates of 12 and 18 months in the high variant group were lower than those in the low variant group （P〈0.05）.Conclusion The risk of all cause death and cardiovascular death in patients with end stage renal disease hemodialysis is significantly higher than that in patients with low blood phosphorus variability,and the stability of serum phosphorus can improve the survival rate of hemodialysis patients and improve their survival.
出处
《疑难病杂志》
CAS
2017年第10期1006-1009,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
血磷变异
血液透析
预后
危险因素
Blood phosphorus variation
Hemodialysis
Prognosis
Risk factor
