[1]张国锐,贾 林,赵 丹,等.老年维持血液透析患者恶性肿瘤发病的相关因素分析[J].医学信息,2022,35(10):113-116.[doi:10.3969/j.issn.1006-1959.2022.10.027]
　ZHANG Guo-rui,JIA Lin,ZHAO Dan,et al.Analysis of Related Factors of Malignant Tumor in Elderly Maintenance Hemodialysis Patients[J].Medical Information,2022,35(10):113-116.[doi:10.3969/j.issn.1006-1959.2022.10.027]
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老年维持血液透析患者恶性肿瘤发病的相关因素分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年10期
页码:
113-116
栏目:
论著
出版日期:
2022-05-15

文章信息/Info

Title:
Analysis of Related Factors of Malignant Tumor in Elderly Maintenance Hemodialysis Patients
文章编号:
1006-1959（2022）10-0113-04
作者:
张国锐; 贾 林; 赵 丹; 等
（石河子大学医学院第一附属医院肾病科，新疆 石河子 832000）
Author(s):
ZHANG Guo-rui; JIA Lin; ZHAO Dan; et al.
(Department of Nephrology,the First Affiliated Hospital of Shihezi University,Shihezi 832000,Xinjiang,China)
关键词:
维持血液透析; 恶性肿瘤; 肾小球滤过率
Keywords:
Maintenance of hemodialysis; Malignant tumor; Glomerular filtration rate
分类号:
R692
DOI:
10.3969/j.issn.1006-1959.2022.10.027
文献标志码:
A
摘要:
目的 观察老年维持血液透析患者发生恶性肿瘤的情况，分析发生恶性肿瘤的高危因素，以期为制定老年维持血液透析患者恶性肿瘤预防方案提供依据。方法 回顾性分析2016年1月-2020年12月在石河子大学第一附属医院行维持性血液透析的325例老年患者的临床资料，将透析期间筛查出恶性肿瘤的患者设为观察组，未发生恶性肿瘤患者设为对照组。分析维持性血液透析患者肿瘤部位及构成情况，采用单因素及多因素分析老年维持血液透析患者发生恶性肿瘤的危险因素。结果 老年维持血液透析患者恶性肿瘤发生率为12.92%，以肾癌、甲状腺癌、肺癌为主；单因素分析显示，两组年龄、BMI、透析时间、尿量、白蛋白水平、Hb水平、iPTH水平、Kt/v、TLC理想百分率比较，差异有统计学意义（P＜0.05）；多因素Logistic回归分析显示，年龄≥70岁、BMI＜23 kg/m2、透析时间≥3年、白蛋白水平＜35 g/L、Kt/v＜1.2、Hb＜110 g/L、iPTH≥300 pg/ml、TLC理想百分率＜70%为老年维持血液透析患者发生恶性肿瘤的高危因素。结论 老年维持血液透析患者发生恶性肿瘤的几率较高，与患者透析时间长、营养状况差、免疫功能受损关系、尿毒症毒素作用有密切关系。
Abstract:
Objective To observe the occurrence of malignant tumors in elderly patients with maintenance hemodialysis and analyze the risk factors for malignant tumors, so as to provide the basis for formulating the prevention scheme of malignant tumors in elderly patients with maintenance hemodialysis.Methods The clinical data of 325 elderly patients undergoing maintenance hemodialysis in the First Affiliated Hospital of Shihezi University from January 2016 to December 2020 were retrospectively analyzed. Patients with malignant tumors screened during dialysis were set as observation group, and patients without malignant tumors were set as control group. The tumor location and composition of maintenance hemodialysis patients were analyzed. Univariate and multivariate analysis were used to analyze the risk factors of malignant tumors in elderly maintenance hemodialysis patients.Results The incidence of malignant tumors in elderly maintenance hemodialysis patients was 12.92%, mainly renal carcinoma, thyroid carcinoma and lung cancer. Single factor analysis showed that there were significant differences in age, BMI, dialysis time, urine volume, albumin level, Hb level, iPTH level, Kt/v and TLC ideal percentage between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥70 years old, BMI<23 kg/m2, dialysis time≥3 years, albumin level<35 g/L, Kt/v<1.2, Hb<110 g/L, iPTH ≥ 300 pg/ml, TLC ideal percentage<70% were risk factors for malignant tumors in elderly MHD patients.Conclusion The incidence of malignant tumor in elderly maintenance hemodialysis patients is high, which is closely related to long dialysis time, poor nutritional status, impaired immune function and uremic toxins.

参考文献/References:

[1]Eneman JD,Philips GK.Cancer management in patients with end-stage renal disease[J].Oncology (Williston Park),2005,19(9):1199-1212.[2]Yoo KD,Lee JP,Lee SM,et al.Cancer in Korean patients with end-stage renal disease:A 7-year follow-up[J].PLoS One,2017,12(7):e0178649.[3]张晓华,李静,王利华.维持性血液透析患者的长期生存分析[J].中国血液净化,2019,18(12):826-829.[4]齐易.维持性透析患者恶性肿瘤的发生情况及相关因素[J].医学信息,2020,33(12):101-102.[5]雷莹,张云芳,钟碧贤,等.不同透析龄的血液透析患者死亡相关危险因素分析[J].中华肾脏病杂志,2019,35(2):147-149.[6]Wielicko M,Pyrza M,Mayszko J.Cancer in dialysis patients[J].Wiad Lek,2020,73(9):2068-2072.[7]Hsiao PJ,Hsieh PF,Chang CH,et al.Higher risk of urothelial carcinoma in the upper urinary tract than in the urinary bladder in hemodialysis patients[J].Ren Fail,2016,38(5):663-670.[8]周海洋,殷胜强,冉亮,等.合并恶性肿瘤的终末期肾病维持性血液透析患者临床特征及预后分析[J].肿瘤预防与治疗,2020,33(6):481-486.[9]张怡玲,尹永红,赵久阳.透析患者并发恶性肿瘤的临床分析[J].大连医科大学学报,2010,32(5):555-557,568.[10]Nagy A,Walter E,Zubakov D,et al.High risk of development of renal cell tumor in end-stage kidney disease: the role of microenvironment[J].Tumour Biol,2016,37(7):9511-9519.[11]Ou CH,Yang WH.Long-term outcomes of complete urinary tract exenteration for dialysis patients with urothelial cancer[J].Int Urol Nephrol,2017,49(4):623-627.[12]Lisowska KA,Pindel M,Pietruczuk K,et al.The influence of a single hemodialysis procedure on human T lymphocytes[J].Sci Rep,2019,9(1):5041.[13]Lisowska KA,Debska-Slizień A,Jasiulewicz A,et al.Hemodialysis affects phenotype and proliferation of CD4-positive T lymphocytes[J].J Clin Immunol,2012,32(1):189-200. [14]Lin MY,Kuo MC,Hung CC,et al.Association of dialysis with the risks of cancers[J].PLoS One,2015,10(4):e0122856.[15]Dai L,Golembiewska E,Lindholm B,et al.End-Stage Renal Disease,Inflammation and Cardiovascular Outcomes[J].Contrib Nephrol,2017(191):32-43.[16]Churchill BM,Patri P.The Nitty-Gritties of Kt/Vurea Calculations in Hemodialysis and Peritoneal Dialysis[J].Indian J Nephrol,2021,31(2):97-110. [17]AlSahow A,Muenz D,Al-Ghonaim MA,et al.Kt/V: achievement, predictors and relationship to mortality in hemodialysis patients in the Gulf Cooperation Council countries: results from DOPPS (2012-18)[J].Clin Kidney J,2020,14(3):820-830. [18]李春雨,杨德鸿,孟越,等.甲状旁腺激素(1-34)对小鼠肺癌骨转移瘤生长的影响[J].南方医科大学学报,2014,34(9):1295-1300.[19]McCarty MF.Parathyroid hormone may be a cancer promoter-an explanation for the decrease in cancer risk associated with ultraviolet light,calcium,and vitamin D[J].Med Hypotheses,2000,54(3):475-482.[20]Kim WT,Bang WJ,Seo SP,et al.Parathyroid hormone is associated with prostate cancer[J].Prostate Int,2020,8(3):116-120.[21]Xu H,Peng W,Yang Z,et al.The association of secondary hyperparathyroidism and myocardial damages in hemodialysis end-stage renal disease patients: assessed by cardiovascular magnetic resonance native T1 mapping[J].J Cardiovasc Magn Reson, 2021,23(1):23. [22]Sabatino A,Regolisti G,Karupaiah T,et al.Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis[J].Clin Nutr,2017,36(3):663-671.[23]路玲.新疆巴楚县维吾尔族妇女HPV感染、高级别宫颈病变及宫颈癌与行为因素、微量元素和维生素的关系研究[D].乌鲁木齐:新疆医科大学,2016.[24]Marshall KM,Loeliger J,Nolte L,et al.Prevalenceof malnutrition and impact on clinical outcomes in cancerservices:A comparison of two time points[J].Clin Nutr,2019,38(2):644-651.

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更新日期/Last Update: 1900-01-01