新医学
新醫學
신의학
NEW CHINESE MEDICINE
2015年
4期
230-235
,共6页
童若宇%陈观生%何凤%罗正茂%王妍春%张虹%童俊容
童若宇%陳觀生%何鳳%囉正茂%王妍春%張虹%童俊容
동약우%진관생%하봉%라정무%왕연춘%장홍%동준용
糖尿病%血液透析%腹膜透析%生存率%死亡风险
糖尿病%血液透析%腹膜透析%生存率%死亡風險
당뇨병%혈액투석%복막투석%생존솔%사망풍험
Diabetes mellitus%Hemodialysis%Peritoneal dialysis%Survival rate%Mortality risk
目的:探讨选择不同透析模式的糖尿病终末期肾脏病(ESRD)患者的死亡风险差异。方法收集104例糖尿病终末期肾脏病患者。根据选择的透析方式,分为血液透析组和腹膜透析组。主要终点事件是死亡。采用 Kaplan-Meier 法分析患者的生存率,采用 Cox 回归分析2组患者发生死亡的危险因素。结果共有104例糖尿病 ESRD 患者纳入本研究,其中血液透析组42例,腹膜透析组62例。腹膜透析组的1、3、5年生存率分别为87%、77%、57%,高于血液透析组。糖尿病腹膜透析组的全因死亡发生率明显高于血液透析组患者(P <0.05)。多因素 Cox 回归发现,与血液透析组相比,腹膜透析组更具有生存优势(HR =0.84,95%CI:0.61~0.95,P <0.05)。糖尿病患者年龄>65岁(HR =1.58,95%CI:1.19~2.75,P <0.05)、同时存在多种并发症(HR =2.05,95%CI:1.95~2.23,P <0.05)、GHbA1c≥7%(HR =1.81,95%CI:1.09~2.29,P <0.05),选择腹膜透析模式较血液透析模式透析有更高的死亡风险。结论糖尿病腹膜透析患者总体生存率高于血液透析患者。然而,糖尿病老龄患者、存在多种并发症,或者血糖控制较差,选择腹膜透析模式具有更高的死亡风险。
目的:探討選擇不同透析模式的糖尿病終末期腎髒病(ESRD)患者的死亡風險差異。方法收集104例糖尿病終末期腎髒病患者。根據選擇的透析方式,分為血液透析組和腹膜透析組。主要終點事件是死亡。採用 Kaplan-Meier 法分析患者的生存率,採用 Cox 迴歸分析2組患者髮生死亡的危險因素。結果共有104例糖尿病 ESRD 患者納入本研究,其中血液透析組42例,腹膜透析組62例。腹膜透析組的1、3、5年生存率分彆為87%、77%、57%,高于血液透析組。糖尿病腹膜透析組的全因死亡髮生率明顯高于血液透析組患者(P <0.05)。多因素 Cox 迴歸髮現,與血液透析組相比,腹膜透析組更具有生存優勢(HR =0.84,95%CI:0.61~0.95,P <0.05)。糖尿病患者年齡>65歲(HR =1.58,95%CI:1.19~2.75,P <0.05)、同時存在多種併髮癥(HR =2.05,95%CI:1.95~2.23,P <0.05)、GHbA1c≥7%(HR =1.81,95%CI:1.09~2.29,P <0.05),選擇腹膜透析模式較血液透析模式透析有更高的死亡風險。結論糖尿病腹膜透析患者總體生存率高于血液透析患者。然而,糖尿病老齡患者、存在多種併髮癥,或者血糖控製較差,選擇腹膜透析模式具有更高的死亡風險。
목적:탐토선택불동투석모식적당뇨병종말기신장병(ESRD)환자적사망풍험차이。방법수집104례당뇨병종말기신장병환자。근거선택적투석방식,분위혈액투석조화복막투석조。주요종점사건시사망。채용 Kaplan-Meier 법분석환자적생존솔,채용 Cox 회귀분석2조환자발생사망적위험인소。결과공유104례당뇨병 ESRD 환자납입본연구,기중혈액투석조42례,복막투석조62례。복막투석조적1、3、5년생존솔분별위87%、77%、57%,고우혈액투석조。당뇨병복막투석조적전인사망발생솔명현고우혈액투석조환자(P <0.05)。다인소 Cox 회귀발현,여혈액투석조상비,복막투석조경구유생존우세(HR =0.84,95%CI:0.61~0.95,P <0.05)。당뇨병환자년령>65세(HR =1.58,95%CI:1.19~2.75,P <0.05)、동시존재다충병발증(HR =2.05,95%CI:1.95~2.23,P <0.05)、GHbA1c≥7%(HR =1.81,95%CI:1.09~2.29,P <0.05),선택복막투석모식교혈액투석모식투석유경고적사망풍험。결론당뇨병복막투석환자총체생존솔고우혈액투석환자。연이,당뇨병노령환자、존재다충병발증,혹자혈당공제교차,선택복막투석모식구유경고적사망풍험。
Objective To compare the difference in the mortality risk among diabetic patients with end-stage kidney disease (ESRD)receiving different dialysis modalities.Methods In total,104 diabetic pa-tients with ESRD were recruited and divided into the hemodialysis (HD)and peritoneal dialysis (PD)groups.The primary endpoint was death.Survival was calculated using Kaplan-Meier method and the risk factors relat-ed to death were assessed by Cox regression analysis between two groups.Results A total of 104 diabetic pa-tients with ESRD were enrolled in this study,included 42 patients treated by HD and 62 patients treated by PD.The 1-,3-and 5-year survival in the PD group were 87%,82%,and 68%,significantly higher com-pared with those in the HD group.The all-cause mortality in the PD group was significantly higher than that in the HD group (P <0.05).Multivariate cox regression analysis revealed that patients in the PD group presented with better survival compared with their counterparts in the HD group (HR =0.84,95%CI:0.61 ~0.95,P<0.05).Elderly diabetic patients aged >65 years (HR =1.58,95%CI:1.19 ~2.75,P <0.05),with multiple complications (HR =2.05,95%CI:1.95 ~2.23,P =0.04)or GHbA1c ≥7% (HR =1.81,95%CI:1.09 ~2.29,P <0.05)receiving PH had a higher mortality risk compared with those undergoing HD.Conclusion The overall survival of diabetic patients in the PD group was higher compared with that in the HD group.However,diabetic patients aged >65 years,with multiple complications or poor control of blood glu-cose undergoing PD had a higher mortality risk than their counterparts receiving HD.