【摘要】 目的 分析腹膜透析(peritoneal dialysis,PD)患者在1年内的生存情况,及可能影响其预后的因素。方法 回顾性分析2006年6月1日~2013年12月31日于北京大学第三医院开始PD治疗的新患者的临床资料,采用Cox回归模型分析影响患者1年内死亡的危险因素。结果 本研究共纳入患者608例,其中1年内死亡患者63例,非死亡患者545例,Cox回归模型分析结果示:开始透析时高龄(HR 1.047,95%Cl 1.024~1.071,P<0.001),低白蛋白血症(HR 0.900,95%Cl 0.854~0.949,P<0.001),尿量少(HR 0.999,95%Cl 0.998~1.000,P=0.003),卧床状态(HR 2.112,95%Cl 1.148~3.885,P=0.016),有截肢病史(HR 10.927,95%CI 1.407~84.846,P=0.022)的患者1年内死亡率高,而透析前在肾内科门诊规律就诊(HR 0.422,95%Cl 0.242~0.737,P=0.002)的患者死亡率低。结论 透析前肾内科门诊规律就诊的PD患者早期预后较好,而开始透析时高龄、卧床状态、有截肢病史、低白蛋白血症、尿量少的患者预后较差。更多还原

【Abstract】 Objective To investigate the survival status within one year and the factors that affect the prognosis in patients on peritoneal dialysis(PD). Methods In this retrospective cohort study, patients who started PD during Jan. 1, 2006 to Dec. 31, 2014 were included. Cox regression model was used to estimate the factors that affect early survival of the patients. Results We recruited 608 patients, in which 63 patients died within one year and 545 patients rmained alive. Cox regression analysis showed that age(HR 1.047, 95% Cl1.024~1.071, P<0.001), hypoalbuminemia(HR 0.900, 95% Cl 0.854~0.949, P<0.001), urine volume(HR0.999, 95% Cl 0.998~1.000, P=0.003), bedridden(HR 2.112, 95% Cl 1.148-3.885, P=0.016) and amputation history(HR 10.927, 95% CI 1.407~84.846, P=0.022) were associated with higher mortality rate, and regular clinic visit pre-dialysis(HR 0.422, 95% Cl 0.242~0.737, P=0.002) was associated with lower mortality rate.Conclusions Regular clinic visit pre-dialysis was associated with better outcome. Patients with advanced age,bedridden status, amputation history, hypoalbuminemia and oliguria were associated with poor outcomes更多还原