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目的 :对糖尿病肾病血液透析患者发生肺炎的相关因素进行探讨,为临床治疗和干预提供理论依据。方法 :选取2010年6月至2015年6月期间于我院血液透析中心进行透析的300例患者作为研究对象。根据患者有无合并糖尿病肾病分为糖尿病肾病组和非糖尿病肾病组。对2组患者肺炎发生情况进行分析,探讨糖尿病肾病血液透析患者发生肺炎的相关因素。结果 :1.糖尿病肾病组患者年龄大,高血压(76%)、脑卒中(32%)发病率明显高于非糖尿病肾病组(63.6%、2.8%),差异具有统计学意义;2.糖尿病肾病组患者BMI更高,舒张压、平均动脉压、血清白蛋白较低,在BMI、eGFR、舒张压、平均动脉压、血清白蛋白等指标方面与非糖尿病肾病组患者相比,差异具有统计学意义;3.共有20例(6.7%)患者发生肺炎,其中糖尿病肾病组有6例,非糖尿病肾病组14例,2组之间差异具有统计学意义。4.多因素COX回归分析高BMI及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素。结论 :高BMI及低血清白蛋白是糖尿病肾病组患者发生肺炎的独立危险因素,对于接受血液透析治疗的糖尿病肾病患者应注意控制体重,预防发生营养不良。
Objective: To explore the related factors of pneumonia in hemodialysis patients with diabetic nephropathy, and to provide theoretical basis for clinical treatment and intervention. Methods: 300 patients who were dialyzed in our hemodialysis center from June 2010 to June 2015 were selected as the research object. According to whether the patients with or without diabetic nephropathy were divided into diabetic nephropathy group and non-diabetic nephropathy group. The incidence of pneumonia in 2 groups of patients was analyzed to explore the related factors of pneumonia in hemodialysis patients with diabetic nephropathy. The incidences of age, hypertension (76%) and stroke (32%) in diabetic nephropathy group were significantly higher than those in non-diabetic nephropathy group (63.6% and 2.8%, respectively) Compared with patients with non-diabetic nephropathy, BMI, diastolic blood pressure, mean arterial pressure and serum albumin in patients with nephropathy were higher than those in non-diabetic nephropathy patients with higher BMI, diastolic blood pressure, mean arterial pressure and lower serum albumin (3) A total of 20 patients (6.7%) developed pneumonia, including 6 cases of diabetic nephropathy group and 14 cases of non-diabetic nephropathy group. The difference between the two groups was statistically significant. The multivariate COX regression analysis of high BMI and low serum albumin in diabetic nephropathy patients with pneumonia was an independent risk factor. Conclusion: High BMI and low serum albumin are independent risk factors of pneumonia in diabetic nephropathy patients. Patients with diabetic nephropathy receiving hemodialysis should pay attention to weight control and prevent malnutrition.