透析患者胆囊结石患病率及其危险因素分析

目的调查透析患者胆囊结石患病情况，探讨其患病率是否高于普通人群，血液透析及腹膜透析患者胆囊结石患病率是否有差别，并分析其可能的原因。方法回顾性分析2009年1月-2012年10月长期随访的358例透析患者（126例血液透析、232例腹膜透析）胆囊结石患病情况，与376例初诊的慢性肾脏病5期患者及普通人群胆囊结石患病率进行比较。结果长期透析患者胆囊结石患病率为23．5％，高于初诊的慢性肾脏病5期患者（14．4％）及普通人群（P=-0．002）。在年龄〈60岁患者中，腹膜透析患者胆囊结石患病率明显高于血液透析患者（P〈0．05），其白蛋白水平明显低于血液透析患者，同时胆固醇、低密度脂蛋白、低密度脂蛋白与高密度脂蛋白比值等指标明显高于血液透析患者。多因素回归分析得出透析患者胆囊结石危险因素有：高龄（OR=2．581，P=-0．001）、女性（OR=2．554，P=0．000）、原发病（糖尿病）（OR=1．947，P=-0．044）、透析时间（OR=1．000，P=0．006）。结论透析患者胆囊结石患病率高于普通人群，腹膜透析比血液透析胆囊结石患病风险增加，透析患者胆囊结石危险因素有：高龄、女性、原发病（糖尿病）、血脂紊乱、低蛋白血症、透析时间等。

The Prevalence and Risk FactOrs of Gallbladder .Stone In Dialysis Patients

Objective To investigate the prevalence of gallbladder stone in dialysis patients, determine whether it is higher than that in the general population, find out the difference of prevalence between hemodialysis and peritoneal dialysis patients, and analyzes the possible causes. Methods We analyzed the prevalence of gallbladder stone in 358 dialysis patients （126 cases of hemodialysis and 232 cases of peritoneal dialysis followed up in our hospital from Janttary 2009 to October 2012. And we compared it with 376 patients diagnosed with chront6 l~tdllo＇~ disease stage 5 （CKD5） and the general population. Results The prevalence of gallbladder stone in dialysis patients followed up in our hospital was 23.5%, which was higher than CKD5 patients （P=0.002）. The prevalence was significantly greater in dlalysis paticnts than that in the general population （P 〈 0.000 5）. In the dialysis patients who were younger than sixty years old, the prevalence of gallbladder stone in peritoneal dialysis patients was obviously higher than that in the hemodialysis patients （P 〈 0.05）. albumin level was significantly lower in peritoneal dialysis patients than in the hemodialysis patients. At the same time, cholesterOl~ low density lipoprotein, and the ratio of low density lipoprotein to high density lipoprotein were much higher with statistical significance. Logistic regression analysis showed that itlereasing age （0R=2.581, P=-0.001）, female （OR=2.554, P=0.000）, the primary disease （diabetes mellitus） （OR=1.947, P=-0.044） arid dialysis period （OR=1.000, P=-0.006） were risk factors for gallbladder stone in dialysis patients. Conclusions The prevat of gallbladder stone in dialysis patients is higher than that in the general population. Peritoneal dialysis patiemts have more risk factors to get gallbladder stone than hemodialysis patients. Risk factors for gallbladder stone in dialysis patients are increasing age, female,primary disease （diabetes mellitus）, dyslipidemia, hypoalbuminemia, long dialysis period and so on.