不同血液透析时相的糖尿病肾病患者预后比较
Comparison of the prognosis in patients with diabetic nephropathy undergoing different phases of hemodialysis

目的 比较不同血液透析（血透）时相（即紧急血透与计划血透）的糖尿病肾病患者的生存情况。方法 纳入2008年6月1日—2015年6月31日接受血透治疗的糖尿病肾病患者，根据患者开始血透的时机分为紧急血透组和计划血透组。收集患者的人口学和临床资料，随访截至2016年1月31日。应用Kaplan-Meier法和Log-rank检验分析患者的生存率。结果 共纳入糖尿病肾病接受血透治疗患者117例，紧急血透组62例，计划血透组55例。紧急血透组病死率（38.7%）显著高于计划血透组（21.8%）（P=0.043）。去除3月内死亡的患者，2组患者开始血透6月~5年内各阶段生存率的差异均无统计学意义。Kaplan-Meier生存曲线分析结果显示：计划血透组患者总体生存率优于紧急血透组患者（P=0.034）。结论 对于糖尿病肾病患者，计划血透患者的总体生存率高于紧急血透患者，且行紧急血透的糖尿病肾病患者死亡的高发时段为开始血透后的3月内。
： Objective To compare the survival rate of patients with diabetic nephropathy (DN) who underwent different phases of hemodialysis (i.e. emergency hemodialysis and planned hemodialysis). Methods Patients with DN who underwent emergency hemodialysis or planned hemodialysis between June 1, 2008 and June 31, 2015 were enrolled. Patients were assigned to the emergency hemodialysis group and the planned hemodialysis group and their demographic and clinical data were collected. Patients were followed up till January 31, 2016. Kaplan Meier method and log rank test were used to analyze the survival rate of the patients. Results A total of 117 DN patients undergoing hemodialysis were enrolled and assigned to the emergency hemodialysis group (n=62) and the planned hemodialysis group (n=55). The mortality rate was significantly higher in the emergency hemodialysis group (38.7%) than in the planned hemodialysis group (21.8%)(P=0.043). Eliminating patients died within three months, the differences in survival rates at each stage from 6 months to 5 years after hemodialysis between the two groups were not statistically significant. Kaplan-Meier survival curve analysis revealed that the overall mortality rate in the planned hemodialysis group was higher as compared with the emergency hemodialysis initially (P=0.034). Conclusion For patients with DN, the overall survival rate in patients undergoing the planned hemodialysis was higher as compared with patients undergoing the emergency hemodialysis. Most deaths in DN patients undergoing emergency hemodialysis occured within beginning three months after hemodialysis