影响维持性血液透析患者预后相关因素的生存分析

收集2004年1月至2009年1月我院的维持性血液透析患者共121例。Kaplan-Meirie分析和Cox回归分析透析前各临床指标对患者生存率的影响。中位随访28．9个月,1年、3年及5年累积生存率分别为93．0％、66．5％、45．8％。结果发现心血管疾病（χ^2=6．582,P=0．010）、尿素清除指数（Kt／V）（χ^2=7．633,P=0．006）、透析年龄（χ^2=12．439,P=0．002）、血清白蛋白水平（χ^2=4．512,P=0．034）与预后最密切。经多变量Cox回归分析,Kt／V、心血管疾病、透析年龄为影响生存率的独立因素,RR值分别为3．204、2．994、2．543。提示透析充分性、心血管疾病及开始透析年龄是影响维持性血液透析患者长期生存的主要因素。

Survival analysis of prognostic associated factors in the maintenance hemodialysis patients

One hundred and twenty one patients on maintenance hemodialysis ( MHD) from Januaury 2004 to Januaury 2009 in our hospital were enrolled in the study. Demographic characteristics, clinical data and causes of disease were documented, the survival probability was estimated with Kaplan-Meier method and the prognostic factors were analyzed with Cox regression model. The median follow-up duration was 28. 9 months. The 1,3, 5-year survival rates were 93. 0% , 66. 5% and 45. 8% respectively. By Kaplan-Meirie analysis, cardiovascular disease (x2 =6. 582, P =0. 010) , age of starting dialysis (x2= 12.439, P= 0.002), urea clearance index Kt/V ( x2 =7.633, P=0.006) and albumin levels ( x2 = 4.512, P= 0.034) were closely related to prognosis. Cox regression analysis showed Kt/V, cardiovascular disease and age of starting dialysis were independent prognostic factors ( relative risk were 3. 204, 2. 994, 2. 543 respectively).