维持性血液透析患者透析充分性相关因素分析

目的：探讨维持性血液透析（MHD）患者透析充分性的影响因素。方法以2008年1月至2012年12月南昌大学第一附属医院血液净化中心378例维持性血液透析患者为研究对象。每月监测患者血红蛋白、肌酐、尿素氮等10余项临床指标，计算得出尿素清除指数（Kt/V）和尿素下降率（URR）。用单因素和多因素分析探讨MHD患者透析充分性与临床指标的关系。结果单因素ANOVA分析显示原发病、年龄、血钠、血钾、血总蛋白、尿素氮、iPTH、血磷、血钙与Kt/V有关。而多重线性回归分析显示年龄、每周透析时间、干体重和血红蛋白是Kt/V的独立影响因素。年龄、每周透析时间、干体重与Kt/V呈负相关（P〈0.05）；血红蛋白与Kt/V呈正相关（P〈0.05）。其中年龄是最主要的因素。结论 MHD患者透析充分性与患者年龄、每周透析时间、血红蛋白和干体重密切相关。

Evaluation of hemodialysis sufficiency analysis of relative influence factors in maintenance hemodialysis patients

Objective To explore influencing factors of the hemodialysis sufficiency in maintenance hemodialysis （MHD） pa-tients. Methods A total of 378 MHD patients from January 2008 to December 2012 in the department of the first affiliated Hospi-tal of Nan Chang University were enrolled in this study. Hemoglobin,creatinine,urea nitrogen and so on more than 10 clinical in-dicators in patients were monitored every month,and the urea clearance index （Kt/V） and urea reduction （URR） were calculated. Univariate and multivariate analysis were used to examine the association between the hemodialysis sufficiency and clinical pa-rameters. Results Single factor ANOVA analysis showed that the primary disease,age,serum sodium,potassium,total protein, blood urea nitrogen,iPTH,blood,blood calcium and phosphorus rerate to Kt/V. And multiple linear regression analysis showed that age,dialysis time every week,dry weight and hemoglobin is the independent impact factors of Kt/V. Kt/V was negatively correlated with age,weekly dialysis time and dry weight（P〈0.05）;and was positively correlated with hemoglobin（P〈0.05）. Among them age is the main factor. Conclusion The hemodialysis sufficiency in MHD patients is closely associated to age,dialysis time every week,hemoglobin and dry weight.