末期病患者的外周动脉疾病:透析结果和实践模式研究 (DOPPS) 的观察结果
Sanjay Rajagopalan1, Santo Dellegrottaglie, Anna L Furniss
1Division of Cardiovascular Medicine, 473 W 12th Ave, Ohio State University, Columbus, OH 43202, USA. Sanjay.Rajagopalan@osumc.edu
Circulation
|October 25, 2006
概括
周围动脉疾病 (PAD) 影响近25%的血液透析患者,增加他们的死亡风险,心血管事件和住院治疗. 此外,PAD还显著降低了患者与健康相关的生活质量.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 末期病 (ESRD) 患者面临心血管并发症的风险增加.
- 周围动脉疾病 (PAD) 在这个人群中是一个重大问题.
- 了解PAD患病率和影响对于改善患者的治疗结果至关重要.
研究的目的:
- 在国际血液透析患者队列中确定PAD的患病率.
- 调查PAD和预后之间的关联,包括死亡率和住院率.
- 评估PAD对血液透析患者与健康相关的生活质量 (HRQOL) 的影响.
主要方法:
- 来自前性国际透析结果和实践模式研究 (DOPPS) 的数据分析,涉及29873名血液透析患者.
- 后勤回归用于识别PAD的相关物.
- 考克斯回归模型用于评估PAD与死亡/住院风险之间的关联.
- 使用HRQOL问卷来评估患者报告的结果.
主要成果:
- 在25.3%的患者中诊断出PAD,具有显著的地理差异.
- PAD的显著相关性包括年龄,男性性别,糖尿病,高血压,吸烟和血液透析持续时间.
- PAD诊断与所有原因死亡率 (HR=1.36),心脏死亡率 (HR=1.43) 和住院治疗 (HR=1.19) 的增加有关.
- 患有PAD的患者在HRQOL问卷中体育健康得分明显较低 (P<0.0001).
结论:
- 周围动脉疾病在血液透析患者中非常普遍.
- PAD独立地与心血管死亡率,发病率和住院的风险显著增加有关.
- 在接受血液透析的患者中,PAD对与健康有关的生活质量产生负面影响.
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