CAJ | 학술논문

目的探讨低钙透析液对持续性不卧床腹膜透析(CAPD)患者生存的影响.方法收集2006年1月1日至2010年12月31日本院腹膜透析中心规律随访的CAPD患者临床资料,随访至2011年12月31日.根据使用透析液钙离子浓度的不同,将患者分为标准钙(1.75 mmol/L)腹膜透析液(SCD)组和低钙(1.25 mmol/L)腹膜透析液(LCD)组,通过COX回归分析两组患者的生存率及影响生存的相关危险因素.结果共纳入982例CAPD患者,其中SCD组634例,LCD组348例.中位随访时间为24.20(3.07～ 72.87)个月,共有162例(16.5％)死亡,其中71例(43.8％)死于心脑血管疾病.SCD组患者1年、3年和5年累积生存率分别为90.9％、74.2％和58.9％；LCD组患者1年、3年和5年累积生存率分别为98.6％、94.0％和76.4％.LCD组患者的生存率显著高于SCD组(P＜0.05),使用LCD可降低CAPD患者59％全因死亡风险.老龄、糖尿病、低血红蛋白水平是影响患者全因死亡的独立危险因素；与标准透析液相比,低钙透析液是生存的保护因素.结论与标准钙透析液相比,CAPD患者使用低钙透析液的生存率更高；老龄、糖尿病和低血红蛋白水平是影响腹膜透析患者预后的独立危险因素.
목적 탐토저개투석액대지속성불와상복막투석(CAPD)환자생존적영향.방법 수집2006년1월1일지2010년12월31일본원복막투석중심규률수방적CAPD환자림상자료,수방지2011년12월31일.근거사용투석액개리자농도적불동,장환자분위표준개(1.75 mmol/L)복막투석액(SCD)조화저개(1.25 mmol/L)복막투석액(LCD)조,통과COX회귀분석량조환자적생존솔급영향생존적상관위험인소.결과 공납입982례CAPD환자,기중SCD조634례,LCD조348례.중위수방시간위24.20(3.07～ 72.87)개월,공유162례(16.5％)사망,기중71례(43.8％)사우심뇌혈관질병.SCD조환자1년、3년화5년루적생존솔분별위90.9％、74.2％화58.9％；LCD조환자1년、3년화5년루적생존솔분별위98.6％、94.0％화76.4％.LCD조환자적생존솔현저고우SCD조(P＜0.05),사용LCD가강저CAPD환자59％전인사망풍험.노령、당뇨병、저혈홍단백수평시영향환자전인사망적독립위험인소；여표준투석액상비,저개투석액시생존적보호인소.결론 여표준개투석액상비,CAPD환자사용저개투석액적생존솔경고；노령、당뇨병화저혈홍단백수평시영향복막투석환자예후적독립위험인소.
Objective To investigate the impact of low calcium dialysate on survival in continuous ambulatory peritoneal dialysis (CAPD)patients.Methods CAPD patients at our PD center between January 1,2006 and December 31,2010 were retrospectively studied.The patients were divided into standard-calcium dialysate (SCD) group and low-calcium dialysate (LCD) group.Cox regression analysis was used to compare patient survival and determine the related risk factors Results A total of 982 eligible PD patients were included in this study,of whom 634 patients treated with standard-calcium dialysate,and 348 with low-calcium dialysate.During a median follow-up of 24.2-month,162(16.5％) died,71(43.8％) of them due to cardiovascular and cerebrovascular diseases.The overall 1-,3-,and 5-year patient survival rates were 90.9％,74.2％ and 58.9％ in SCD group and 98.6％,94.0％ and 76.4％ in LCD group.Cox regression analysis demonstrated that low calcium dialysate treatment reduced 59％ risk of all-cause death,as compared with standard calcium dialysate exposure.Old age,diabetes status and lower hematoglobin were independent risk factors of all -cause death in CAPD patients.Conclusion The survival rate of CAPD patients using LCD isobviously higer than that using SCD.Old age,diabetes status and lower haematoglobin are independent risk factors of all-cause death in CAPD patients.