| 阳慧,王康杰,黄冠文,李逸,季风,游怀舟,张天嵩,陈靖,王梦婧.维持性血液透析患者死亡风险因素的荟萃分析[J].老年医学与保健,2025,31(2):360-365,382 |
| 维持性血液透析患者死亡风险因素的荟萃分析 |
| A meta-analysis of risk factors for death in maintenance hemodialysis patients |
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| DOI：10.3969/j.issn.1008-8296.2025.02.012 |
| 中文关键词: 血液透析 死亡 风险因素 荟萃分析 |
| 英文关键词: hemodialysis death risk factor meta-analysis |
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| 中文摘要: |
| 目的 本研究旨在通过荟萃分析明确影响老年血液透析患者死亡风险的共性因素,以便为临床治疗提供重要的参考价值.方法 研究检索了截至2024年5月12日发表在中国知网、万方数据库、PubMed、Cochrane Library、Web of Science上关于血液透析患者死亡影响因素的队列研究.2名研究者独立筛选文献、评估质量并提取数据.使用Stata 18.0软件进行数据分析,包括效应量合并、异质性来源的Meta回归分析、敏感性分析及发表偏倚评估.结果 纳入30项研究,总样本量90 671例,影响因素30项.Meta分析揭示年龄、BMI、脉压、白蛋白、CRP及多种合并症(糖尿病、高脂血症、心血管疾病等)是影响血液透析患者死亡风险的关键因素.其中高BMI(HR=0.97,95％CI=0.97～0.98)、高白蛋白(HR=0.60,95％CI=0.50～0.72)和高脂血症(HR=0.85,95％CI=0.79～0.91)降低死亡风险.结论 高BMI、高白蛋白及高脂血症与老年血液透析患者死亡风险降低显著相关,需制定个体化营养干预策略并优化共病管理以改善预后. |
| 英文摘要: |
| Objective To identify common factors influencing mortality risk in elderly hemodialysis patients through Meta-analysis,and provide important reference value for clinical treatment.Methods Cohort studies on factors influencing mortality risk in hemodialysis patients published in CNKI,Wanfang Database,PubMed,Cochrane Library,and Web of Sci-ence up to May 12,2024,were systematically searched.Two researchers independently screened literature,assessed quality,and extracted data.Data analysis was performed using Stata 18.0 software,including effect size pooling,Meta-regression for heterogeneity sources,sensitivity analysis,and publication bias evaluation.Results 30 studies were included,with a total sample size of 90 671 cases and 30 influencing factors.Meta-analysis revealed that age,BMI,pulse pressure,albumin,CRP,and multiple comorbidities(diabetes,hyperlipidemia,cardiovascular disease,and etc.)were the key factors affecting mortali-ty risk in hemodialysis patients.Among them,high BMI(HR=0.97,95％CI=0.97-0.98),high albumin(HR=0.60,95％CI=0.50-0.72),and hyperlipidemia(HR=0.85,95％CI=0.79-0.91)reduced the mortality risk.Conclusion High BMI,high albumin,and hyperlipidemia are significantly associated with a reduced risk of mortality in elderly hemodialysis pa-tients.Individualized nutrition intervention strategies need to be developed and comorbidity management optimized to improve prognosis. |
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