不同年龄维持性血液透析患者微量元素水平变化及对生存质量的影响
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摘要
目的探讨不同年龄维持性血液透析患者微量元素水平变化及其对生存质量的影响。方法选取我院维持性血液透析100例为观察组,其中年龄≥65岁为老年组(n=56),<65岁为中青年组(n=44);选取同期体检健康的50例为对照组。观察各组微量元素水平变化,记录健康状况问卷量表(SF-36)评分,探讨微量元素与维持性透析的相关性,分析不同SF-36评分患者微量元素水平变化及影响因素。结果与对照组比较,观察组铁、锌的水平降低,硒、铜的水平升高,差异有统计学意义(P<0.05);与中青年组比较,老年组铁、锌的水平及各维度SF-36评分明显降低,硒、铜的水平明显升高,差异有统计学意义(P<0.05)。Pearson相关性分析显示,铁、锌含量与年龄呈负相关(r=-0.124,P=0.004;r=-0.452,P=0.000),硒、铜含量与年龄呈正相关(r=0.232,P=0.012;r=0.132,P=0.010)。随着SF-36评分的降低,维持性血液透析患者体内铁、锌含量逐渐减少,硒、铜含量逐渐升高,比较差异有统计学意义(P<0.05)。多元线性回归分析显示,铁、锌、硒、铜均为SF-36评分的独立影响因素。结论不同年龄维持性血液透析患者体内微量元素水平的变化与生存质量密切相关。
Objective To explore the changes of trace elements levels in patients with maintenance hemodialysis( MHD) at different ages and their effects on survival quality. Methods A total of 100 patients with MHD were selected as the observation group,which was subdivided into the elderly group( ≥65 years old) and the young and middle-aged group( < 65 years old). In the meantime,another 50 healthy examiners were selected as the control group. The changes of trace elements levels were observed among groups,and short-form health status questionnaire( SF-36) was recorded. The correlation between MHD and trace elements was explored,and the levels of trace elements and the influencing factors were analyzed in patients with different SF-36 scores. Results The levels of iron and zinc were lower whereas the levels of selenium and copper were higher in the observation group,as compared with those in the control group( P < 0. 05). Compared with the young and middle-aged group,the levels of iron and zinc and all-dimension scores of SF-36 scale were significantly lower whereas the levels of selenium and copper were significantly higher in the elderly group( P < 0. 05). Pearson correlation analysis showed that iron and zinc contents were negatively correlated with age( r =-0. 124,P = 0. 004; r =-0. 452,P = 0. 000),and selenium and copper were positively correlated with age( r = 0. 232,P = 0. 012; r = 0. 132,P = 0. 010). With the decrease of SF-36 scores,the levels of iron and zinc in the body of MHD patients were decreased gradually while the levels of selenium and copper were increased gradually( P < 0. 05). Multiple linear regression analysis revealed that iron,zine,selenium and copper were independent influencing factors of SF-36 scores. Conclusion The changes of trace elements in MHD patients at different ages are closely associated with the survival quality.
Objective To explore the changes of trace elements levels in patients with maintenance hemodialysis( MHD) at different ages and their effects on survival quality. Methods A total of 100 patients with MHD were selected as the observation group,which was subdivided into the elderly group( ≥65 years old) and the young and middle-aged group( < 65 years old). In the meantime,another 50 healthy examiners were selected as the control group. The changes of trace elements levels were observed among groups,and short-form health status questionnaire( SF-36) was recorded. The correlation between MHD and trace elements was explored,and the levels of trace elements and the influencing factors were analyzed in patients with different SF-36 scores. Results The levels of iron and zinc were lower whereas the levels of selenium and copper were higher in the observation group,as compared with those in the control group( P < 0. 05). Compared with the young and middle-aged group,the levels of iron and zinc and all-dimension scores of SF-36 scale were significantly lower whereas the levels of selenium and copper were significantly higher in the elderly group( P < 0. 05). Pearson correlation analysis showed that iron and zinc contents were negatively correlated with age( r =-0. 124,P = 0. 004; r =-0. 452,P = 0. 000),and selenium and copper were positively correlated with age( r = 0. 232,P = 0. 012; r = 0. 132,P = 0. 010). With the decrease of SF-36 scores,the levels of iron and zinc in the body of MHD patients were decreased gradually while the levels of selenium and copper were increased gradually( P < 0. 05). Multiple linear regression analysis revealed that iron,zine,selenium and copper were independent influencing factors of SF-36 scores. Conclusion The changes of trace elements in MHD patients at different ages are closely associated with the survival quality.
引文
[1]李海坚,冯永民,路杰,等.维持性血液透析患者钙磷代谢紊乱分析[J].中国基层医药,2010,17(8):1059-1061.
[2]冯亚平,张福先,张昌明,等.296例维持性血液透析患者动静脉内瘘建立的临床分析[J].医学临床研究,2010,27(5):789-791.
[3]王晓刚.血液透析在儿童危重症的临床应用[J].中国小儿急救医学,2008,15(3):203-206.
[4]邹洪,胡建,胡睿东,等.联合应用血液灌流与血液透析对重症急性胰腺炎患者抑制性T细胞的影响及疗效[J].中国普通外科杂志,2014,23(3):301-304.
[5]陈晓婕,覃晓波,张琴,等.维持性血液透析患者透析前后血电解质变化对心率变异性的影响[J].中国医药导报,2012,9(35):71-72,80.
[6]林正均,罗昭强,金仙勇.血液透析的不同模式治疗急性肾功能衰竭患者的有效性及对肾功能、电解质的影响[J].安徽医药,2016,20(2):316-319.
[7]张梅,黄雯,岳英,等.老年维持性血液透析患者住院原因及相关因素分析[J].中华保健医学杂志,2013,15(2):110-113.
[8]孔祥瑞.必需微量元素的营养、生理及临床意义[M].合肥:安徽科学技术出版社,1982:11.
[9]石建华.微量元素与糖尿病及其并发冠心病的关系[J].蚌埠医学院学报,1988,13(2):137-139.
[10]曹志茹.微量元素锌与儿童生长发育关系的探讨[J].中国妇幼保健,2013,28(24):3969-3970.
[11]席玉美,游茂翔.维持性血液透析患者血清锌、铁、钙、铜、镁的检测分析[J].医师进修杂志,2002,25(2):39-40.
[12]蒋艳丽.慢性肾功不全尿毒症患者血液透析前后血清微量元素的改变[J].医学综述,1995,22(8):363-365.
[13]冯文,袁玲.维持性血液透析患者的营养指导[J].中国基层医药,2008,15(12):2090-2092.
[14]韩晓丽,曾炜,钟杰,等.150例维持性血液透析患者微量元素测定结果分析[J].中华全科医师杂志,2013,12(8):636-637.
[15]王增.减少血液铜含量可“饿死”癌细胞[J].东方药膳,2016,(12):9.
[16]顾一峰,卫刚,江玉贞,等.不同年龄维持性血液透析患者透析效果和营养状态分析[J].中国血液净化,2006,5(1):51-52.
[17]洪海兰,王莲凤,黄冬玲,等.不同年龄维持性血液透析患者健康相关生活质量分析[J].解放军护理杂志,2009,26(13):28-30.
[18]李敏,程静,严冬仙.不同年龄段维持性血液透析患者的心理分析与护理对策[J].实用临床医学,2014,15(1):116-117,119.
[19]康兆恒,谢桂庭,肖哲红,等.硒缺乏与人体疾病[J].国外医学(医学地理分册),2002,23(1):13-16.
[2]冯亚平,张福先,张昌明,等.296例维持性血液透析患者动静脉内瘘建立的临床分析[J].医学临床研究,2010,27(5):789-791.
[3]王晓刚.血液透析在儿童危重症的临床应用[J].中国小儿急救医学,2008,15(3):203-206.
[4]邹洪,胡建,胡睿东,等.联合应用血液灌流与血液透析对重症急性胰腺炎患者抑制性T细胞的影响及疗效[J].中国普通外科杂志,2014,23(3):301-304.
[5]陈晓婕,覃晓波,张琴,等.维持性血液透析患者透析前后血电解质变化对心率变异性的影响[J].中国医药导报,2012,9(35):71-72,80.
[6]林正均,罗昭强,金仙勇.血液透析的不同模式治疗急性肾功能衰竭患者的有效性及对肾功能、电解质的影响[J].安徽医药,2016,20(2):316-319.
[7]张梅,黄雯,岳英,等.老年维持性血液透析患者住院原因及相关因素分析[J].中华保健医学杂志,2013,15(2):110-113.
[8]孔祥瑞.必需微量元素的营养、生理及临床意义[M].合肥:安徽科学技术出版社,1982:11.
[9]石建华.微量元素与糖尿病及其并发冠心病的关系[J].蚌埠医学院学报,1988,13(2):137-139.
[10]曹志茹.微量元素锌与儿童生长发育关系的探讨[J].中国妇幼保健,2013,28(24):3969-3970.
[11]席玉美,游茂翔.维持性血液透析患者血清锌、铁、钙、铜、镁的检测分析[J].医师进修杂志,2002,25(2):39-40.
[12]蒋艳丽.慢性肾功不全尿毒症患者血液透析前后血清微量元素的改变[J].医学综述,1995,22(8):363-365.
[13]冯文,袁玲.维持性血液透析患者的营养指导[J].中国基层医药,2008,15(12):2090-2092.
[14]韩晓丽,曾炜,钟杰,等.150例维持性血液透析患者微量元素测定结果分析[J].中华全科医师杂志,2013,12(8):636-637.
[15]王增.减少血液铜含量可“饿死”癌细胞[J].东方药膳,2016,(12):9.
[16]顾一峰,卫刚,江玉贞,等.不同年龄维持性血液透析患者透析效果和营养状态分析[J].中国血液净化,2006,5(1):51-52.
[17]洪海兰,王莲凤,黄冬玲,等.不同年龄维持性血液透析患者健康相关生活质量分析[J].解放军护理杂志,2009,26(13):28-30.
[18]李敏,程静,严冬仙.不同年龄段维持性血液透析患者的心理分析与护理对策[J].实用临床医学,2014,15(1):116-117,119.
[19]康兆恒,谢桂庭,肖哲红,等.硒缺乏与人体疾病[J].国外医学(医学地理分册),2002,23(1):13-16.