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老年维持性血液透析患者患恶性肿瘤的影响因素分析
作者：张立华1  高永宁1  马慧鹏1  王柱2 
单位：1. 河北医科大学第二医院 血液透析科, 河北 石家庄 050000;
2. 河北医科大学第二医院 妇科, 河北 石家庄 050000
关键词：维持性血液透析 恶性肿瘤 影响因素 老年人 
分类号：R459
出版年·卷·期（页码）：2023·42·第四期（607-612）
摘要：

目的:探究老年维持性血液透析(MHD)患者患恶性肿瘤(MT)的影响因素。方法:选择2021年1月至12月河北医科大学第二医院收治的372例老年MHD患者为研究对象,将MHD期间并发MT的患者作为MT组(41例),未并发MT的患者作为N-MT组(331例);分析影响老年MHD患者发生MT的相关因素;采用多因素Logistic回归分析影响老年MHD患者MT发生的危险因素。结果:老年MHD患者MT发生率为11.02%。N-MT组与MT组性别、家族MT史、吸烟史、合并高血压、合并糖尿病的差异均无统计学意义(P>0.05),年龄、体质量指数(BMI)、尿量、透析龄、白蛋白、全段甲状旁腺激素(iPTH)、血红蛋白(Hb)、尿素清除指数(Kt/v)及总淋巴细胞计数(TLC)理想百分率差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,透析龄＞48个月、白蛋白≥30 g·L-1、TLC理想百分率<70%是老年MHD患者合并MT的独立危险因素(P＜0.05)。结论:老年MHD患者MT发生率约为11.02%,透析龄＞48个月、白蛋白≥30 g·L-1、TLC理想百分率<70%是老年MHD患者合并MT的独立危险因素。

Objective: To investigate the current situation and influencing factors of malignant tumor(MT) in elderly maintenance hemodialysis(MHD) patients. Methods: A total of 372 elderly MHD patients admitted to the Second Hospital of Hebei Medical University from January 2021 to December 2021 were selected as the study subjects; the clinical data of elderly MHD patients were collected; patients with MT during MHD were treated as MT group(41 cases), and patients without MT were treated as N-MT group(331 cases); the related factors affecting MT in elderly MHD patients were analyzed; multivariate Logistic regression was applied to analyze the risk factors of MT in the elderly MHD patients. Results: The incidence of MT in elderly MHD patients was 11.02%; there was no obvious difference between N-MT group and MT group in gender, family MT history, smoking history, hypertension and diabetes(P>0.05); there were obvious differences between N-MT group and MT group in age, body mass index(BMI), urine volume, dialysis age, albumin, intact parathyroid hormone(iPTH), hemoglobin(Hb), urea clearance index(Kt/v) and ideal percentage of total lymphocyte count(TLC)(P<0.05); multivariate Logistic regression analysis showed that dialysis age >48 months, albumin ≥30 g·L-1, and ideal percentage of TLC <70% were independent risk factors for elderly MHD patients with MT(P<0.05). Conclusion: The incidence of MT in elderly MHD patients is about 11.02%. Among them, dialysis age >48 months, albumin ≥30 g·L-1, and the ideal percentage of TLC <70% are independent risk factors for elderly MHD patients with MT.
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