摘要
目的了解威海市居民终末期肾病(ESRD)主要病因、流行特征与治疗状况、不同人群透析治疗群体差异,为政府制定卫生政策提供科学依据。方法对2007～2009年威海市居民ESRD流行和治疗状况在摸底的基础上进行抽样调查,依据调查结果进行资料统计分析。结果威海市居民ESRD的时点患病率为33.01/10万,2007～2009年的ESRD调整死亡率分别为3.72/10万、4.27/10万、6.91/10万,呈逐年增高的趋势(χ2=26.20,P<0.01)。主要原发疾病依次为慢性肾小球肾炎、糖尿病肾病、高血压肾病,三者占总构成的70%以上,3种疾病对ESRD的演进过程有差异(χ2=31.57,P<0.01)。现症透析病例的医保参保比例高于死亡透析病例(χ2=81.39,P<0.01),死亡透析病例中农民比例高于现症透析病例(χ2=22.69,P<0.01)。现症病例的透析治疗率(63.83%)高于死亡病例(41.37%,χ2=15.84,P<0.01),规范透析率二者比较接近。结论 ESRD是危害本地区居民健康的重大疾病,慢性非传染性疾病是导致ESRD的主要病因。经济状况是决定患者透析与否及生存结局的主要因素。提高医保覆盖率及保障水平,探索ESRD等大病医疗保障制度建设是解决当前ESRD患者看病贵的重要环节。
Objective To grasp the main causes of disease, general epidemiologic feature, the treatment condation and the difference in End-stage renal disease group, to provide scienctific proof of formulating health policy for the government. Methods The epidemiologic feature of End-stage renal disease of the local residents of Weihai city from 2007 to 2009 was in- vestigated and statistical analysis on the basis of the investigation results was processed. Results The time point prevalence rate of the End-stage renal disease of the local residents was 33.01/105 ,the adjusted mortality rate of the ESRD residents was 3.72/ 105,4.27/105 and 6.91/105 during 2007 -2009 ,the adjusted mortality rate was significantly enhanced every year（ X2 = 26.20, P 〈 0.01 ）. The main congenital diseases was chronic glomerulonephritis, diabetic nephropathy and hypertensive renal disease in turn. They accounted for over 70% of the total congenital diseases. The effect of the evolution to ESRD of the three congenital dis- eases was significantly different. The proportion of medical insurance was significantly higher in dialysis cases than in dead dialy- sis cases（ X~ = 81.39 ,P 〈 0.01 ）. The proportion of farmers was significantly higher in dead dialysis cases than in dialysis cases （~2 = 22.69 ,P 〈 0.01 ）. The dialysance of cases （63.83%） was significantly higher than dead cases （41.37%）, x^2 = 15.84, P 〈 0.01. The normative dialysance was approximate in the two group. Conclusion ESRD was the important disease which en- dangering the local residents, the chronic non-communicable disease was the main etiology of ESRD. The financial situation was the main factor which can influenced dialysance and the final result. We should enhangce the coverage ratio of medical insurance and the levels of assurance, and exploring the building of Medical Security System is the main link which can solve the problem of expensive to seek medical care.
出处
《中华全科医学》
2013年第1期111-113,共3页
Chinese Journal of General Practice
关键词
终末期肾病
血液透析
影响因素
End-stage renal disease
Hemodialysis
Influence factor
