末期脏病患者的透析方式和中风事件:基于注册表的队列研究
Ching-Hsiu Peng1, Tsung-Han Hsieh2, Ting-Wen Chu3,4
1Division of Nephrology (C.-H.P., T.-Y.L., S.-C.H.), Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien, Taiwan.
Stroke
|October 10, 2023
概括
与血液透析相比,腹膜透析患者面临的缺血性中风风险更高. 需要进一步的研究来探索透析患者中风的预防策略.
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
- 流行病学 流行病学
背景情况:
- 被透析的末期病 (ESKD) 患者患中风的风险很高.
- 透析方式与脑血管疾病风险之间的关联尚未得到充分证实.
研究的目的:
- 在接受腹腔透析 (PD) 和血液透析 (HD) 的患者中,比较发生中风的风险.
主要方法:
- 使用台湾国家医疗保险研究数据库对39542名开始透析的ESKD患者 (2010-2014年) 的回顾性研究.
- 倾向性得分匹配创造了3,809名PD患者和11,427名HD患者 (1:3比率) 的队列.
- 考克斯的比例危险模型分析了包括急性缺血性中风,出血性中风,急性冠状动脉综合征和全因死亡率在内的结果.
主要成果:
- 腹膜透析与急性缺血性中风的风险显著增加有关 (sHR,1.32;P=0.0005).
- 在PD和HD之间的出血性中风 (sHR,0.89;P=0.3571) 或急性冠状动脉综合征 (sHR,0.99;P=0.9080) 风险中没有发现显著差异.
- 与HD相比,患PD的患者有较高的全因死亡风险 (aHR,1.24;P<0.0001).
结论:
- 腹腔透析与血液透析相比,与急性缺血性中风的风险增加有关.
- 需要进一步的研究来调查PD患者的脑血管预防策略,以减轻中风风险.
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