107例维持性血液透析患者死亡原因分析

摘要

Objective To analyze the characteristics and cause of death of the maintenance hemodialysis( MHD) patients. Methods 107 death patients with MHD for more than 3 months were collected in the 174th Chinese People's Liberation Army Hospi-tal( the Success Affiliated Hospital of Xiamen University) . These patients were divided into 2 groups: young-middle age group (<60 years of age) , elderly group(>60 years age) . Clinical features and cause of death were analyzed among the two groups. Results Of the 107 death cases, 75 cases were males and 32 cases were females, and the mean age was (62. 55±15. 31) years and the age was 22-91 years. 42 cases were in young-middle group (31 cases were males and 11 cases were females). 65 cases were in elderly group ( 44 cases were males and 21 cases were females) . Sex difference was significant among the two groups ( P<0. 01) . Dialysis age of the young-middle group was longer than the elderly group [(50. 12±30. 55) months vs (37. 6±37. 12) months] (P<0. 01). The pathogen-ic disease of young-middle group was mainly chronic glomerulonephritis ( 57. 14%) , and the elderly group was diabetic nephropathy ( 43. 08%) . The cases of death in groups were different. In the young-middle group, 33. 33% ( 14 cases) died of cerebral vascular, es-pecially cerebral hemorrhage ( 30. 95%) . In the elderly group, causes of death were cardiovascular disease, infections, cerebral vascu-lar disease, sudden death syndrome and malnutrition-inflammation-atherosclerosis syndrome (MIA syndrome). Conclusion The causes of death were different between the two groups, and the major cause of death in young-middle group is cerebral vascular disease. Causes of death in elderly patients were various, including cardiovascular disease, infections, sudden death syndrome and MIA.%目的 分析行规律血液透析治疗患者的死亡原因及临床特点.方法 收集解放军第174医院(厦门大学附属成功医院)血液净化中心2006年1月至2016年1月血液透析大于3个月的死亡患者共107例,根据年龄将其分为小于或等于60岁的青中年组及大于60岁的老年组,分析两组死亡患者临床资料及死亡原因.结果 107例死亡患者中,男75例,女32例,年龄22~91岁,平均年龄(62.55±15.31)岁.其中青中年组42例,男31例,女11例;老年组65例,男44例,女21例;两组患者在性别上差异有统计学意义(P<0.01).青中年组透龄明显长于老年组[(50.12±30.55)月vs(37.6±37.12)月],两组透龄差异有统计学意义(P<0.01).青中年组原发病以慢性肾小球肾炎为主,比例为57.14%,老年组以糖尿病性肾病居多,比例为43.08%.两组患者主要死亡原因有所不同,青中年组33.33%(14例)死于脑血管疾病,其中以脑出血(30.95%)居多.老年组死亡原因以心血管疾病、感染、脑血管疾病、猝死和营养不良-炎症-动脉粥样硬化综合征(malnutrition-inflammation-atherosclerosis syndrome,MIA Syndrome)为主.结论 死亡原因在不同年龄组有所差异,青中年组患者脑血管疾病多见,老年组患者死亡原因不一,包括心脑血管疾病、感染、猝死和MIA综合征.