国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2014年
3期
20-22
,共3页
洪大情%吴姝焜%张月%杨鸿玲%王君如%王莉
洪大情%吳姝焜%張月%楊鴻玲%王君如%王莉
홍대정%오주혼%장월%양홍령%왕군여%왕리
肾透析%外周血管疾病%死亡率%踝肱指数
腎透析%外週血管疾病%死亡率%踝肱指數
신투석%외주혈관질병%사망솔%과굉지수
Renal dialysis%Peripheral vascular diseases%Mortality%Ankle-brachial index
目的 通过测量踝肱指数(ABI)调查维持性血液透析(MHD)患者下肢外周动脉疾病(PAD),观察其与透析患者全因死亡的关系.方法 纳入四川省人民医院血液净化中心177例MHD患者,收集其一般资料、透析前血压、实验室检查结果,并测量ABI.以任何一侧ABI＜0.90作为下肢动脉缺血的诊断标准,随访29个月,采用Kaplan-Meier及Cox回归分析下肢动脉疾病与患者全因死亡的关系.结果 下肢缺血PAD的患病率为12.5％ (22/177),PAD组患者年龄较高[(67±16)岁比(58± 15)岁,P=0.017].Kaplan-Meier分析提示,PAD组患者生存率低于无PAD组(P＜0.001);Cox分析显示,校正年龄、性别、透析龄、糖尿病、冠心病之后,PAD患者死亡风险是无PAD患者的3.39倍(95％可信区间1.44～7.97,P=0.005),糖尿病(风险比=2.917,95％可信区间1.280～6.649,P=0.011)和年龄(风险比=1.042,95％可信区间1.007～ 1.077,P=0.018)也是该人群死亡的危险因素.结论 MHD患者外周血管疾病患病率较高,PAD、糖尿病和年龄是MHD患者死亡的独立危险因素.
目的 通過測量踝肱指數(ABI)調查維持性血液透析(MHD)患者下肢外週動脈疾病(PAD),觀察其與透析患者全因死亡的關繫.方法 納入四川省人民醫院血液淨化中心177例MHD患者,收集其一般資料、透析前血壓、實驗室檢查結果,併測量ABI.以任何一側ABI＜0.90作為下肢動脈缺血的診斷標準,隨訪29箇月,採用Kaplan-Meier及Cox迴歸分析下肢動脈疾病與患者全因死亡的關繫.結果 下肢缺血PAD的患病率為12.5％ (22/177),PAD組患者年齡較高[(67±16)歲比(58± 15)歲,P=0.017].Kaplan-Meier分析提示,PAD組患者生存率低于無PAD組(P＜0.001);Cox分析顯示,校正年齡、性彆、透析齡、糖尿病、冠心病之後,PAD患者死亡風險是無PAD患者的3.39倍(95％可信區間1.44～7.97,P=0.005),糖尿病(風險比=2.917,95％可信區間1.280～6.649,P=0.011)和年齡(風險比=1.042,95％可信區間1.007～ 1.077,P=0.018)也是該人群死亡的危險因素.結論 MHD患者外週血管疾病患病率較高,PAD、糖尿病和年齡是MHD患者死亡的獨立危險因素.
목적 통과측량과굉지수(ABI)조사유지성혈액투석(MHD)환자하지외주동맥질병(PAD),관찰기여투석환자전인사망적관계.방법 납입사천성인민의원혈액정화중심177례MHD환자,수집기일반자료、투석전혈압、실험실검사결과,병측량ABI.이임하일측ABI＜0.90작위하지동맥결혈적진단표준,수방29개월,채용Kaplan-Meier급Cox회귀분석하지동맥질병여환자전인사망적관계.결과 하지결혈PAD적환병솔위12.5％ (22/177),PAD조환자년령교고[(67±16)세비(58± 15)세,P=0.017].Kaplan-Meier분석제시,PAD조환자생존솔저우무PAD조(P＜0.001);Cox분석현시,교정년령、성별、투석령、당뇨병、관심병지후,PAD환자사망풍험시무PAD환자적3.39배(95％가신구간1.44～7.97,P=0.005),당뇨병(풍험비=2.917,95％가신구간1.280～6.649,P=0.011)화년령(풍험비=1.042,95％가신구간1.007～ 1.077,P=0.018)야시해인군사망적위험인소.결론 MHD환자외주혈관질병환병솔교고,PAD、당뇨병화년령시MHD환자사망적독립위험인소.
Objective To investigate the impact of peripheral artery disease on mortality diagnosed by ankle-brachial index (ABI) in maintenance hemodialysis patients.Methods One hundred and seventyseven MHD patients were enrolled and general information,predialysis brood pressure,laboratory findings and ABI were collected.PAD was diagnosed according to ABI ＜ 0.9.Kaplan-Meier and Cox regression were applied to analyzed the relationship between PAD and patient mortality after 29 months,follow up.Results PAD prevalence among this population was 12.8％ (22/177).Patients with PAD were older.Kaplan-Meier analysis showed that the survival probability of PAD patients was lower than non-PAD patients.Cox regression showed PAD was independently associated with higher mortality after adjusting for age,gender,hemodialysis vintage,diabetes and coronary artery disease (hazard ratio (HR)) =3.39,95 ％ confidence interval (CI),1.44-7.97,P =0.005).Conclusions The prevalence of PAD among MHD patients is relatively high,and PAD is independently associated with lower survival.
