摘要
目的探讨老年维持性血液透析患者死亡原因及导致其死亡的主要危险因素。方法对2010年6月在我科血液透析中心进行维持性血液透析治疗3个月以上、有完整基本资料登记、年龄≥60岁老年患者105例临床资料进行回顾性分析，观察至2013年6月30日。结果105例患者中位年龄69岁，中位透析龄27个月。截止2013年6月30日死亡33例，主要死因为心血管疾病11例（33．3％）、肺部感染7例（21．2％）及脑血管疾病5例（15．2％）。死亡组患者年龄、合并心血管疾病比例及外周血管钙化评分明显高于非死亡组，死亡组合并高血压比例、血浆白蛋白水平明显低于非死亡组。COX回归分析结果显示，校正年龄、体质指数、尿素清除指数及钙化评分等因素后，合并心血管疾病（HR=2．143，95％CI：1．010～4．613，P=0．049）、不合并高血压（HR=0．293，95％CI：0．097-0．889，P=0．03）及低血浆白蛋白（HR=0．838，95％CI：0．748-0．904，P=0．002）是老年维持性血液透析患者死亡的主要危险因素。结论心脑血管疾病及肺部感染是老年患者死亡的主要原因，营养不良及心血管系统并发症是患者死亡的主要危险因素。
Objective To analyze of causes of death in elderly patients undergoing maintenance hemodialysis （MHD） and their major risk factors. Methods A total of 105 patients aged ≥60 years under MHD treatment for more than 3 months from Jun 2010 were included with complete basic registration information in this retrospective cohort study. The deadline of the follow-up was 30 Jun 2013. Results Among 105 patients, the median age was 69 years and the median dialysis duration was 27 months. 33 patients died during the follow up period. The main causes for death were cardiovascular disease （11 cases, 33.3 % ） , infection （7 cases, 21.2 %） and cerebrovascular disease （5 eases, 15.2%）. Age and the proportion of patients with cardlovascular diseases and peripheral vascular calcification score were higher, and the proportion of hypertension patients was lower in death group than in survival group. After adjusting for age, body mass Index, kt/v, and calcification score, COX regression analysis indicated that complications with cardiovascular disease （HR= 2. 143, 950/oo CI： 1.010-4.613, P=0.049）, without hypertension （HR=0.293, 95% Ch 0. 097-0. 889, P= 0.03）, and with lower serum level of albumin （ HR=0. 838, 950/oo CI： 0. 748-0. 904, P=0. 002） were the main risk factors for mortality in elderly patients on MHD. Conclusions The main causes for death in elderly MHD patients are cardiovascular disease, infection and eerebrovascular disease. Malnutrition and the comorbidity of cardiovascular disease might be the main risk factors for mortality in elderly MHD patients.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2015年第7期767-770,共4页
Chinese Journal of Geriatrics
基金
四川省卫生厅课题（110239）
