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老年维持性血液透析并充血性心力衰竭患者生存状况的影响因素

  

  1. 解放军航空医学研究所附属医院 a.内二科;b.内四科, 北京  100089
  • 出版日期:2016-10-05 发布日期:2016-10-11
  • 通讯作者: 通信作者:王雁,Email:wang_yan466@sina.com

Influence factors analysis on clinical outcomes of  elderly patients of hemodialysis with congestive heart failure

  1. a.Second Department of Internal Medicine;b.Fourth Department of Internal Medicine,
    the Hospital  attached to Aeromedicine Institute of PLA, Beijing 100089, China
  • Online:2016-10-05 Published:2016-10-11
  • Contact: Corresponding author: Wang Yan, Email: wang_yan466@sina.com

摘要: 目的探讨影响老年维持性血液透析(MHD)合并充血性心力衰竭(CHF)患者生存时间的危险因素。方法选择2008年1月1日至2015年12月31日期间曾因MHD合并CHF住过院、又因CHF再入院或死亡患者46例,另选32例老年MHD未合并CHF或仅合并1次CHF患者为对照,通过门诊收集临床资料,以CHF再入院或全因死亡为终点事件(生存时间终止),随访截止时间为2015年12月31日。通过KaplanMeier生存曲线和COX比例风险回归模型分析患者生存时间的影响因素。结果KaplanMeier生存曲线显示年龄、左心室扩大或肥厚、感染、左心室射血分数(LVEF)、透析间期体质量增加对老年MHD合并CHF患者的生存时间有显著影响(P<0.05)。COX比例风险回归模型分析显示年龄、左心室扩大或肥厚、LVEF、透析间期体质量增加为影响老年MHD患者CHF生存时间的独立危险因素(P<0.05)。结论年龄分层、左心室扩大或肥厚、透析间期体质量增加、LVEF降低是影响老年维持性血液透析并CHF患者生存时间的独立危险因素。

关键词: 肾透析; 心力衰竭;心室功能,

Abstract: ObjectiveTo discuss the  risk factors of the survival time for the elderly maintenance hemodialysis(MHD)  patients with congestive heart failure. MethodsFrom the period of January 1, 2008 to December 31, 2015, a total of 46 elderly patients hospitalized for the reason of maintenance hemodialysis with congestive heart failure(CHF) and rehospitalized or dead for the reason of CHF were selected, and 32 patients of maintenance hemodialysis without CHF or presented CHF for only one time were selected as control. The clinical information from outpatient service was colleted and the followup was terminated on December 31, 2015 or rehospitalization because of CHF or allcause mortality (termination of survival time). The risk factors affecting survival time for the patients were analyzed using KaplanMeier survival curve and Cox proportional hazard regression model. ResultsThe KaplanMeier survival curve showed that age, left cardiomegaly, infection, left ventricular ejection fraction (LVEF) and dialysis interphase weight gain had distinct effects on the survival time for the elderly paitents of maintenance hemodialysis with CHF(P<0.05).The Cox proportional hazard regression model showed that age,left cardiomegaly, LVEF value and dialysis interphase weight gain were independent risk factors affecting  the survival time for the elderly patients of the maintenance hemodialysis with CHF(P<0.05).ConclusionAge stratification, left cardiomegaly, dialysis interphase weight gain and LVEF reduction are the independent risk factors affecting  the survival time for the elderly patients of the maintenance hemodialysis with CHF.

Key words: renal dialysis;heart , failure;ventricular function, left