Wakasugi Minako, Matsuo Koji, Kazama Junichiro James, Narita Ichiei
Center for Inter-organ Communication Research, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
Ther Apher Dial. 2015 Feb;19(1):45-9. doi: 10.1111/1744-9987.12192. Epub 2014 Sep 4.
Cerebrovascular diseases, including intracerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage, remain prevalent causes of morbidity and mortality among dialysis patients. Their mortality rate for cerebrovascular diseases is roughly three times higher than that in the general population. However, whether mortality rates for all subtypes of cerebrovascular diseases are equally higher has not been evaluated. The aim of this study was to determine the mortality rate for each stroke subtype, comparing dialysis patients and the general population in Japan. We used mortality data reported by the Japanese Society for Dialysis Therapy and national Vital Statistics data between 2008 and 2009. We calculated standardized mortality ratios and compared the mortality rates for stroke subtypes including intracerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage. During the 2-year study period, 51 994 and 933 deaths from intracerebral hemorrhage, 79 124 and 511 deaths from cerebral infarction, and 24 957 and 147 deaths from subarachnoid hemorrhage were recorded per 252 million person-years and per 546 474 dialysis patient-years, respectively. Standardized mortality ratios among dialysis patients relative to the general population were 3.8 (95% confidence interval, 3.6-4.1), 1.3 (1.2-1.4), and 1.3 (1.1-1.6) for intracerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage, respectively. Intracerebral hemorrhage was the highest cause of mortality in the dialysis population, although cerebral infarction was the highest in the general population. Relative to the general population in Japan, Japanese dialysis patients had higher mortality rates, especially for intracerebral hemorrhage.
脑血管疾病，包括脑出血、脑梗死和蛛网膜下腔出血，仍然是透析患者发病和死亡的常见原因。他们脑血管疾病的死亡率大约是普通人群的三倍。然而，所有脑血管疾病亚型的死亡率是否同样更高尚未得到评估。本研究的目的是确定每种中风亚型的死亡率，比较日本的透析患者和普通人群。我们使用了日本透析治疗学会报告的死亡率数据以及2008年至2009年的国家生命统计数据。我们计算了标准化死亡率，并比较了包括脑出血、脑梗死和蛛网膜下腔出血在内的中风亚型的死亡率。在为期2年的研究期间，每2.52亿人年和每546474透析患者年分别记录了933例脑出血死亡、51994例，511例脑梗死死亡、79124例，以及147例蛛网膜下腔出血死亡、24957例。相对于普通人群，透析患者中脑出血、脑梗死和蛛网膜下腔出血的标准化死亡率分别为3.8（95%置信区间，3.6 - 4.1）、1.3（1.2 - 1.4）和1.3（1.1 - 1.6）。脑出血是透析人群中最高的死亡原因，尽管脑梗死在普通人群中是最高的。相对于日本普通人群，日本透析患者的死亡率更高，尤其是脑出血。
