农村与城镇终末期肾病患者临床状况比较分析

对比分析农村与城镇终末期肾病患者的临床状况，旨在了解新农合政策带给农村终末期肾病患者的益处及今后还需完善和努力之处。对广西壮族自治区人民医院血液净化治疗中心2007年新增的238例终末期肾病患者按农村与城镇进行分组对比分析。96例农村患者，88例选择血液透析，8例放弃治疗；142例城镇患者，23例选择腹膜透析，108例血液透析，11例放弃。无论是城镇还是农村患者慢性肾炎为主要的原发病、都存在透析过晚、并发症发生率高、急诊透析率高的现象。与城镇组相比，农村组患者平均年龄、肾病知晓率、残余肾功能、血红蛋白、二氧化碳结合力、尿素清除指数低于城镇组（P〈0．05）；梗阻性肾病发病率、并发症发生率、急诊透析率、死亡率、失访率高于城镇组（P〈0．05）。新农合的实施使农村终末期肾病患者获得了治疗的机会，针对农村患者肾病知晓率低、临床状况差的特点，需加强农村慢性肾病的防治工作。

Investigation and Consideration on Intentional Transmission of HIV/AIDS

To compare the clinical conditions between the rural and urban patients with end stage of renal disease （ESRD）, 238 patients （96 rural and 142 urban patients）enrolled in 2007 were included in the study. Patients＇ laboratory data, residual renal function, nutritional status, cause of renal failure, morbidities and mortality were evaluated. Glomerulonephritis was the main primary disease of ESRD in both groups. Both of two groups had high rates of delay dialysis, morbidities and emergent dialysis. Compared with urban patients, the rural patients were younger（47.2 vs. 54. 6 years）, the rates of knowledge（12.5% vs. 52.8%}, Ccr（4.9 vs. 7. 9 ml/ min）, serum hemoglobin（5.9 vs. 8.4 g/L）, bicarbonate（9.6 vs. 13.2 mmol/L）, KT/v（4.9 vs. 7.9 ） were significantly lower（P〈0.05）. The rates of emergent dialysis （79.2% vs. 33.8 % ）, morbidities（ 100.0 % vs. 78.9 %）, mortality（28.1% vs. 17.6 %）, failed to follow up（26.0 % vs. 12.0 %） were significantly higher（P〈0.05）. Compared with urban patients with ESRD, rural patients had higher rate of constructive nephropathy, lower rate of known nephrosis, the clinical statues were worse. The government and society should paid more attention to rural patients with ESRD.