慢性肾衰竭腹膜透析患者的预后分析

目的分析慢性肾衰竭腹膜透析患者的生存率及预后影响因素。方法回顾性调查2003年1月至2011年6月在我院规律随访的353例腹膜透析患者，总结患者的预后和退出原因，比较死亡患者与继续腹膜透析患者临床指标差异，分析患者死亡的危险因素和独立危险因素。结果353例患者中退出159例，其中死亡74例，死亡原因主要是心血管疾病。腹膜透析患者1年、2年、3年、4年的生存率分别为92％、80％、68％、58％。Logistic回归分析显示，年龄、糖尿病肾病、血红蛋白、血白蛋白和血肌酐是患者死亡的危险因素。COX回归分析显示，年龄、血红蛋白和血肌酐是死亡的独立危险因素（均P〈0．05）。结论根据年龄、血红蛋白和血肌酐水平可以对腹膜透析患者预后做初步判断，重视患者的营养状况，有利于改善预后、降低死亡率。

Prognosis of patients with chronic renal failure subject to peritoneal dialysis

Objective To analyze the survival rate and prognosis-related factors of patients with chronic renal failure undergoing peritoneal dialysis. Methods We retrospectively investigated 353 peritoneal dialysis patients from Jan. 2003 to Jun. 2011. Prognosis and exit reasons were analyzed, and clinical indicators between died patients and continuing peritoneal dialysis patients were compared. The mortality risk factors and independent risk factors were analyzed. Results Among the 159 exited pa- tients,74 patients died. The main cause of death was angiocardiopathy. The overall survival rate after 1,2,3 and 4 years was 92%, 80%,68% and 58%, respectively. Logistic regression analysis showed that age,DKD, hemoglobin, blood albumin and blood creatinine were mortality risk factors. COX regression analysis showed that age, hemoglobin and blood ereatinine were independent mortality risk factors （P〈0. 05）. Conclusions We could preliminarily predict prognosis of peritoneal dialysis patients based on age, hemoglobin and blood creatinine. In order to improve prognosis and reduce death rate, we should attach importance to nutrition status.