军事医学2016，Vol.40Issue(8)：672-675,4.DOI:10.7644/j.issn.1674-9960.2016.08.013
老年维持性血液透析患者短期死亡因素分析
Causes of early death in elderly patients undergoing maintenance hemodialysis
王艺萍 1覃莲香 1杨乃宁 1余永武2
作者信息
- 1. 航天中心医院 北京大学航天临床医学院，北京 100049
- 2. 海军总医院肾脏病科，北京 100036
- 折叠
摘要
Abstract
Objective To analyze the causes of early death in elderly patients undergoing maintenance hemodialysis ( MHD) and major risk factors.Methods A retrospective study was conducted.Fourty-three patients who had undergone MHD between January 2005 and December 2015 and died within 3 -12 months after hemodialysis in the Hemodialysis Center of China Aerospace Center Hospital were included in Group A while 106 patients who had undergone hemodialysis in the same period but survived for over 12 months were selected as control group(Group B).Results The main causes of early death of 43 elderly patients with MHD were cardiovascular ( 46.5%) and cerebrovascular diseases ( 25.6%) (CCVD), and infections(14.0%).The age,proportion of patients with diabetes and CVD,and the proportion of patients using the central venous catheter( CVC) as vascular access were higher in Group A,but the level of hemoglobin and serum albumin was lower.Indicators of cardiac structure and function showed that the left ventricular end-diastolic diameter (LVDd),left ventricular posterior wall thickness(LVPWT),and left ventricular myocardial quality index(LVMI)in Group A were well above those in Group B, but EF and E/A ratio were significantly lower(P<0.05 and P<0.01).COX regression analysis indicated that the comorbidity with CVD, a lower level of serum albumin and EF were the main risk factors for early mortality in elderly patients under MHD.Conclusion The main cause of early death in elderly MHD patients is CCVD.The comorbidity of CVD, malnutrition and decreased left ventricular systolic function might be the main risk factors for early mortality in elderly MHD patients.Early and adequate dialysis,active treatment of underlying diseases, and the correction of hypoalbuminemia can decrease complications,prolong life and improve the quality of life.关键词
老年/血液透析/短期死亡/危险因素/肾透析/心血管疾病Key words
elderly/maintenance hemodialysis/early death/risk factors/renal dialysis/cardiovascular diseases分类
医药卫生引用本文复制引用
王艺萍,覃莲香,杨乃宁,余永武..老年维持性血液透析患者短期死亡因素分析[J].军事医学,2016,40(8):672-675,4.
