维持性血液透析患者血清磷水平与健康相关生活质量的关系 #br#

目的 探讨血液透析患者血磷水平与健康相关生活质量（HDQOL）的关系。方法 维持性血液透析患者 190例，血磷水平>1.78 mmol/L患者作为高磷血症组（n=108），血磷水平≤1.78 mmol/L患者作为非高磷血症组（n =82）。记录患者年龄、性别、吸烟史、血液透析通路、每周血液透析次数及合并症等临床资料；记录患者血液透析前各项实验室检查指标：血清钙（Ca2+）、血清磷（P）、血清白蛋白（ALB）、全段甲状旁腺素（iPTH）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、血肌酐（Cr）、血尿酸（UA）、碱性磷酸酶等。比较 2组间 iPTH、ALB 及各指标的差异，多因素 Logistic 分析与血磷水平相关的影响因素。采用肾脏疾病生活质量-36 （KDQOL-36）量表进行生活质量评估，计算 KDQOL-36量表中 5个亚量表的得分，比较 2组间各亚量表的差异，分析 血磷水平与生活质量的关系。结果 与非高磷血症组相比，高磷血症组患者年龄小，动静脉内瘘比例高，Cr、ALB、 iPTH、Ca2+水平高（均 P＜0.05）。多因素 Logistic 分析结果示，高 ALB（OR=1.243,95%CI:1.082~1.427）、高 iPTH（OR=1.001，95%CI：1.000~1.002）是高磷血症的危险因素（均 P＜0.05）。高磷血症组各亚量表分数明显低于非高磷血症组（均 P＜0.05）。结论 血磷水平影响维持性血液透析患者生活质量，高磷血症组生活质量更差。

Relationship between serum phosphorus levels and health-related quality of life in#br# patients with maintenance hemodialysis #br#

Objective To investigate the relationship between serum phosphorus levels and health-related quality of life (HDQOL) in hemodialysis patients. Methods A total of 190 patients with maintenance hemodialysis were selected. The patients with blood phosphorus level >1.78 mmol/L were selected as the hyperphosphatemia group (n=108), and the patientswith blood phosphorus level ≤1.78 mmol/L were selected as the non-hyperphosphatemia group (n =82). Data of age, gender,smoking history, hemodialysis access, frequency/week of hemodialysis treatment, complications and other clinical data wererecorded. All the laboratory indicators before hemodialysis were recorded: serum calcium (Ca2+ ), serum phosphorus (P), serum albumin (ALB), total parathyroid hormone (iPTH), total cholesterol (Tc), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), serum creatinine (Cr), blood uric acid (UA) and alkaline phosphatase. The differences in iPTH, ALB and other indicators were compared between the two groups. Multivariate Logistic analysis was performed to analyze the risk factors related to serum phosphorus level. The questionnaire of Kidney Disease Quality of Life 36 (KDQOL-36) was used to evaluate the quality of life, and the scores of five subscales in the KDQOL-36 were calculated. The differences of each subscale were compared between the two groups, and the relationship between blood phosphorus level and quality of life was analyzed. Results Compared with the non-hyperphosphatemia group, the patient age was smaller, the number of arteriovenous internal fistula were more, and the levels of Cr, ALB, iPTH and Ca2+ were higher in hyperphosphatemia group (P＜0.05). Multivariate Logistic analysis indicated that high ALB (OR= 1.243,95%CI:1.082-1.427) and high iPTH (OR=1.001,95%CI:1.000-1.002) were risk factors for hyperphosphatemia (P＜ 0.05). The subscale scores were significantly lower in the hyperphosphatemia group than those of the non-hyperphosphatemia group (P＜0.05). Conclusion The serum phosphorus level affects the quality of life of patients with maintenance hemodialysis, while the quality of life is worse in hyperphosphatemia.