慢性肾衰竭维持性血液透析患者肺部感染的危险因素分析

目的 探讨慢性肾衰竭维持性血液透析患者肺部感染的危险因素。 方法 回顾性研究2011年1月-2016年12月在金华市中心医院血液净化中心维持性血液透析 ≥ 6个月的344例患者资料,其中男性179例(52.0%),女性165例(48.0%),平均年龄(56.7±16.3)岁。根据透析病程中是否有肺部感染,将其分为肺部感染组52例(15.1%)和非肺部感染组292例(84.9%)。观察2组患者人口学资料、既往病史、首次透析前肾功能指标、钙磷代谢指标、贫血指标、基础肾病构成。采用Logistic回归分析分析维持性血液透析患者肺部感染的危险因素。 结果 Logistic多因素回归分析显示,年龄 ≥ 60岁(OR=1.833,95% CI:1.216~2.521,P=0.023)、糖尿病(OR=1.542,95% CI:1.178~2.934,P=0.035)、心功能分级(OR=3.325,95% CI:2.154~5.243,P<0.001)和血红蛋白<70 g/L(OR=2.119,95% CI:1.745~3.634,P=0.014)是维持性血液透析患者肺部感染的独立危险因素。 结论 肺部感染是血液透析患者常见的并发症,年龄 ≥ 60岁、糖尿病、心功能分级和血红蛋白<70 g/L是其独立危险因素,需对其进行早期评估和干预。 

Risk factors of pulmonary infection in chronic renal failure patients undergoing maintenance hemodialysis

Objective To investigate the risk factors for pulmonary infection in chronic renal failure patients undergoing maintenance hemodialysis. Methods A total of 344 patients undergoing maintenance hemodialysis with a duration of more than 6 months from January, 2011 to December, 2016 in the department of blood purification center in Jinhua Municipal Central Hospital were reviewed retrospectively. Among them, 179 cases (52.0%) were male and 165 cases (48.0%) were female. The mean age was (56.7 ± 16.3) years. The 344 patients were dichotomized into the pneumonia group (52 cases, 15.1%) and the non-pneumonia group (292 cases, 84.9%), based on whether or not suffering pneumonia on the duration of hemodialysis. The data of the two groups, including demography, medical history, and renal function before the first time of hemodialysis, the level of calcium phosphorus metabolism and anemia, proportion of kidney disease were analyzed. Logistic regression analysis was applied to reveal the risk factors of pneumonia in patients undergoing hemodialysis. Results Multivariate Logistic regression analysis revealed that age ≥ 60 years (OR=1.833, 95% CI:1.216-2.521, P=0.023), diabetes mellitus (OR=1.542, 95% CI:1.178-2.934, P=0.035), cardiac functional grading (OR=3.325, 95% CI:2.154-5.243, P<0.001) and hemoglobin (Hb) <70 g/L (OR=2.119, 95% CI:1.745-3.634, P=0.014) were independent risk factors. Conclusion Pneumonia is a common complication in the patients undergoing hemodialysis. Age ≥ 60 years, diabetes mellitus, cardiac functional grading and Hb < 70 g/L are independent risk factors of pneumonia in the patients undergoing hemodialysis, which need the early assessment and intervention.