本文選題：血液透析　切入點(diǎn)：腹膜透析　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究抗中性粒細(xì)胞胞漿抗體(antineutrophil cytoplasmic antibody,ANCA)相關(guān)性小血管炎(ANCA associated vasculitis,AAV)維持性透析患者的預(yù)后情況以及危險(xiǎn)因素分析,為判斷病情、選擇治療提供依據(jù)。方法回顧性分析2008年6月-2016年6月在浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院腎臟病中心治療并隨訪的AAV維持性透析患者資料,按ANCA類型分組比較器官受累情況、按透析方式分組比較感染情況、統(tǒng)計(jì)死亡原因、應(yīng)用Kaplan-Meier法及Cox回歸模型分析患者生存情況。結(jié)果入選123例AAV維持性透析患者,平均透析時(shí)間為1005±738天,其中腹膜透析(PD)35例(28.5%),血液透析(HD)88例(71.5%),中位隨訪34個(gè)月,患者死亡39例(31.7%)。AAV患者肺臟和腎臟受累多見,感染和心血管事件是主要死亡原因。按ANCA類型分組比較發(fā)現(xiàn)C-ANCA陽性組患者更易出現(xiàn)眼部損害。按透析方式分組比較發(fā)現(xiàn)HD組患者肺部感染發(fā)生率更高。單因素K-M法生存分析對(duì)比HD治療組和PD治療組,患者生存率差異無統(tǒng)計(jì)學(xué)意義。多因素COX回歸模型分析顯示年齡≥65歲、透析前患心血管疾病、透析前患間質(zhì)性肺炎是影響AAV維持性透析患者生存的獨(dú)立危險(xiǎn)因素。結(jié)論AAV維持性透析患者應(yīng)用HD治療或者PD治療,患者生存率差異無統(tǒng)計(jì)學(xué)意義。感染和心血管事件是AAV維持透析患者的主要死亡原因。年齡≥65歲、透析前心血管疾病史及透析前間質(zhì)性肺炎史是影響AAV維持性透析患者生存的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to study the prognosis and risk factors of maintenance dialysis patients with antineutrophil cytoplasmic antibody-Anca (ANCA associated vasculitis AAVA). Methods the data of AAV maintenance dialysis patients treated and followed up in the first affiliated Hospital of Zhejiang University Medical College from June 2008 to June 2016 were analyzed retrospectively. The organ involvement was compared according to ANCA type. Kaplan-Meier method and Cox regression model were used to analyze the survival of the patients. Results the average dialysis time was 1005 鹵738 days in 123 patients with AAV maintenance dialysis. There were 35 cases of PDD with PDD and 71.5 cases with HD of hemodialysis. The median follow-up was 34 months, 39 cases died and 39 cases suffered from lung and kidney involvement. Infection and cardiovascular events were the main causes of death. Compared with ANCA group, C-ANCA positive group was more prone to ocular damage, and HD group had higher incidence of pulmonary infection according to dialysis method. Methods Survival analysis was used to compare HD group with PD group. There was no significant difference in the survival rate of the patients. Multivariate COX regression analysis showed that the age 鈮，

本文編號(hào)：1645714