维持性血液透析患者生活质量评价及影响因素分析
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摘要
目的评价维持性血液透析(MHD)患者的生活质量,并探讨其影响因素。方法选择2014年1月至2016年5月期间武汉科技大学附属医院肾内科收治的102例MHD患者为研究对象纳入病例组,并选择同期100例健康体检者纳入对照组,采用SF-36量表对两组研究对象进行生活质量评价。同时,调查病例组患者的临床资料,对生活质量相关影响因素进行统计学分析。结果病例组患者SF-36量表中的生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感职能(RE)及精神健康(MH)等各个维度得分均明显低于对照组,差异均有统计学意义(P<0.05);单因素分析显示,年龄≥60岁、女性、单身、糖尿病肾病、透析龄长(≥1年)、尿素清除指数(Kt/V)<1.2、营养不良、抑郁的MHD患者其SF-36总分显著较低(P<0.05);多元逐步回归分析显示,年龄、营养状态、Kt/V及抑郁均为影响MHD患者生活质量的独立危险因素(P<0.05)。结论 MHD患者生活质量普遍较低,高龄、营养不良、透析充分性差及抑郁是影响患者生活质量的独立危险因素。
Objective To investigate the quality of life and its influencing factors in patients of maintenance hemodialysis(MHD). Methods A total of 102 patients of MHD, who admitted to Department of Nephrology of the Affiliated Hospitals of Wuhan University of Science and Technology from January 2014 to May 2016, were selected as the case group, and 100 healthy subjects were included into the control group during the same period. The 36-item short-form health survey(SF-36) scale was used to evaluate the quality of life of the two groups. At the same time, the clinical data of MHD patients were investigated, and the influencing factors of quality of life were statistically analyzed.Results The scores of physical functioning(PF), limitations due to physical health problems role-physical(RP), body pain(BP), general health(GH), vitality(VT), social functioning(SF), limitations due to emotional health problems(role-emotional; RE), and mental health(MH) in the SF-36 scale in the case group were significantly lower than the control group(P<0.05). Single factor analysis showed the SF-36 score in MHD patients with age≥60 years old, female, single, diabetic nephropathy, dialysis duration(≥1 years), Kt/V<1.2, malnutrition and depression were significantly lower(P<0.05). Multiple stepwise regression analysis showed that age, nutritional status, Kt/V and depression were independent risk factors affected the quality of life in MHD patients(P<0.05). Conclusion The quality of life of MHD patients is generally low, and the elderly, malnutrition, poor dialysis adequacy and depression are the independent risk factors affecting the quality of life.
Objective To investigate the quality of life and its influencing factors in patients of maintenance hemodialysis(MHD). Methods A total of 102 patients of MHD, who admitted to Department of Nephrology of the Affiliated Hospitals of Wuhan University of Science and Technology from January 2014 to May 2016, were selected as the case group, and 100 healthy subjects were included into the control group during the same period. The 36-item short-form health survey(SF-36) scale was used to evaluate the quality of life of the two groups. At the same time, the clinical data of MHD patients were investigated, and the influencing factors of quality of life were statistically analyzed.Results The scores of physical functioning(PF), limitations due to physical health problems role-physical(RP), body pain(BP), general health(GH), vitality(VT), social functioning(SF), limitations due to emotional health problems(role-emotional; RE), and mental health(MH) in the SF-36 scale in the case group were significantly lower than the control group(P<0.05). Single factor analysis showed the SF-36 score in MHD patients with age≥60 years old, female, single, diabetic nephropathy, dialysis duration(≥1 years), Kt/V<1.2, malnutrition and depression were significantly lower(P<0.05). Multiple stepwise regression analysis showed that age, nutritional status, Kt/V and depression were independent risk factors affected the quality of life in MHD patients(P<0.05). Conclusion The quality of life of MHD patients is generally low, and the elderly, malnutrition, poor dialysis adequacy and depression are the independent risk factors affecting the quality of life.
引文
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[10]胡学芹,陈文,李军.维持性血液透析老年终末期肾脏病患者营养状况及其影响因素分析[J].疑难病杂志,2014,13(5):527-528,531.
[11]陈建祥,杨林燕,徐宏.复方α酮酸对老年维持性血液透析患者微炎症、营养状态及生活质量的影响[J].中国老年学杂志,2016,36(10):2474-2475.
[12]李井娜.血液透析患者液体入依从性影响因素分析[J].中国医药,2012,7(3):304-306.
[13]陈碧琴,黄静蓉,谢晓元,等.维持性血液透析患者生活质量、睡眠质量与透析充分性相关研究[J].现代预防医学,2014,41(17):3168-3170.
[14]李钦君,张长岭,张曙光,等.持续性不卧床腹膜透析患者焦虑和抑郁状态及其相关因素探究[J].中国血液净化,2012,11(6):321-324.
[15]孙静,曹成琦,王丽娟.血液透析患者抑郁状况及其与自我效能和社会支持的相关性研究[J].护理管理杂志,2012,12(5):313-315.
[2]周晓娟,赵庆华,刘丽萍.维持性血液透析患者症状负担与生活质量相关性研究[J].第三军医大学学报,2013,35(5):464-467.
[3]Dehesa-Lopez E,Correa-Rotter R,Olvera-Castillo D,et al.Clinical,dialytic,and laboratory factors associated with poor health-related quality of life in mexican patients on hemodialysis[J].Rev Invest Clin,2016,68(4):192-200.
[4]赖寒,甘华.血液透析患者预后的研究进展[J/CD].中华临床医师杂志(电子版),2011,5(9):2677-2679.
[5]边晓慧,刘大军,郑华,等.维持性血液透析患者预后的五年随访研究[J].中国全科医学,2014,17(7):777-780.
[6]王山,樊文洁,俞婉琦,等.SF-36量表应用于城市化居民生命质量评价的信度和效度分析[J].中华流行病学杂志,2016,37(3):344-347.
[7]姜敏敏,李鲁.SF-36量表在血透患者中的性能测试[J].中国行为医学科学,2003,12(1):31.
[8]易景娜,陈利群,贾守梅,等.390名社区居家高龄老年人生活质量现状及影响因素分析[J].全科护理,2011,9(32):2921-2924.
[9]姚伦,冯广杰.高龄肾功能衰竭患者维持性血液透析的临床研究[J].中国实用医药,2011,6(20):106-107.
[10]胡学芹,陈文,李军.维持性血液透析老年终末期肾脏病患者营养状况及其影响因素分析[J].疑难病杂志,2014,13(5):527-528,531.
[11]陈建祥,杨林燕,徐宏.复方α酮酸对老年维持性血液透析患者微炎症、营养状态及生活质量的影响[J].中国老年学杂志,2016,36(10):2474-2475.
[12]李井娜.血液透析患者液体入依从性影响因素分析[J].中国医药,2012,7(3):304-306.
[13]陈碧琴,黄静蓉,谢晓元,等.维持性血液透析患者生活质量、睡眠质量与透析充分性相关研究[J].现代预防医学,2014,41(17):3168-3170.
[14]李钦君,张长岭,张曙光,等.持续性不卧床腹膜透析患者焦虑和抑郁状态及其相关因素探究[J].中国血液净化,2012,11(6):321-324.
[15]孙静,曹成琦,王丽娟.血液透析患者抑郁状况及其与自我效能和社会支持的相关性研究[J].护理管理杂志,2012,12(5):313-315.