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目的调查透析患者胆囊结石患病情况,探讨其患病率是否高于普通人群,血液透析及腹膜透析患者胆囊结石患病率是否有差别,并分析其可能的原因。方法回顾性分析2009年1月-2012年10月长期随访的358例透析患者(126例血液透析、232例腹膜透析)胆囊结石患病情况,与376例初诊的慢性肾脏病5期患者及普通人群胆囊结石患病率进行比较。结果长期透析患者胆囊结石患病率为23.5%,高于初诊的慢性肾脏病5期患者(14.4%)及普通人群(P=0.002)。在年龄<60岁患者中,腹膜透析患者胆囊结石患病率明显高于血液透析患者(P<0.05),其白蛋白水平明显低于血液透析患者,同时胆固醇、低密度脂蛋白、低密度脂蛋白与高密度脂蛋白比值等指标明显高于血液透析患者。多因素回归分析得出透析患者胆囊结石危险因素有:高龄(OR=2.581,P=0.001)、女性(OR=2.554,P=0.000)、原发病(糖尿病)(OR=1.947,P=0.044)、透析时间(OR=1.000,P=0.006)。结论透析患者胆囊结石患病率高于普通人群,腹膜透析比血液透析胆囊结石患病风险增加,透析患者胆囊结石危险因素有:高龄、女性、原发病(糖尿病)、血脂紊乱、低蛋白血症、透析时间等。
Objective To investigate the prevalence of gallstone in dialysis patients and investigate whether the prevalence of gallstone is higher than that in the general population. Whether there is a difference in the prevalence of gallstone in hemodialysis or peritoneal dialysis, and analyze the possible causes. Methods A retrospective analysis of 358 cases of dialysis patients (126 cases of hemodialysis and 232 cases of peritoneal dialysis) gallbladder stones with long-term follow-up from January 2009 to October 2012 was conducted with 376 cases of newly diagnosed chronic kidney disease patients and normal The prevalence of gallstone in the population was compared. Results The prevalence of gallstone in long-term dialysis patients was 23.5%, higher than that of newly diagnosed patients with stage 5 chronic kidney disease (14.4%) and the general population (P = 0.002). Among patients aged <60 years, the prevalence of gallstone in peritoneal dialysis patients was significantly higher than that in hemodialysis patients (P <0.05), and their albumin levels were significantly lower than those in hemodialysis patients. Cholesterol, low density lipoprotein, low density lipoprotein Protein and high-density lipoprotein ratio and other indicators were significantly higher than hemodialysis patients. Multivariate regression analysis showed that the risk factors of gallstone in dialysis patients were elderly (OR = 2.581, P = 0.001), female (OR = 2.554, P = 0.000) ), Dialysis time (OR = 1.000, P = 0.006). Conclusion The prevalence of gallstone in dialysis patients is higher than that in the general population. The risk of peritoneal dialysis is higher than that of hemodialysis gallstone patients. The risk factors of gallstone in dialysis patients are elderly, female, primary disease (diabetes), dyslipidemia, Disease, dialysis time and so on.