老年腹膜透析患者生存质量的影响因素

目的 探讨持续不卧床腹膜透析(CAPD)老年患者的生存质量状况,并初步探讨影响老年CAPD患者生存质量的各种因素.方法 选取我院2011年至2014年4月期间收治的年龄大于60岁的行持续不卧床腹膜透析治疗的63例老年患者,按年龄分为＜70岁和≥70岁两组,使用SF-36量表调查患者的生存质量.结果 两组患者年龄[(63.93±2.97)vs(73.57±3.22)岁]、Charlson合并症指数(3.4+±2.3 vs 5.0± 3.1)、Karnofsky活动指数(82±9 vs72± 16)、合并心血管并发症(x2=9.921,P=0.002)差异有统计学意义(均P＜0.05).两组患者SF-36量表中8个维度比较差异无统计学意义(均P＞ 0.05);在躯体健康相关生存质量方面差异有统计学意义(P=0.031).相关性分析显示,SF-36总分与Kamofsky活动指数(r=0.046,P=0.000)、残肾功能(r=0.314,P=0.012)呈正相关;与焦虑指数(r=-0.318,P=0.014)、抑郁指数(r=-0.341,P=0.006)呈负相关.躯体健康相关生存质量与年龄(r=-0.337,P=0.007)、是否合并心血管并发症(r=-0.333,P=0.008)、抑郁指数(r=-0.369,P=0.003)呈负相关;与Karnofsky活动指数(r=0.507,P=0.000)、残余肾功能(r=0.268,P=0.034)呈正相关性.精神健康相关生存质量与焦虑指数(r=-0.327,P=0.009)、抑郁指数(r=-0.267,P=0.034)呈负相关;与Karnofsky活动指数(r =0.321,P=0.01)、残余肾功能(r=0.283,P=0.025)呈正相关.结论 对于老年腹膜透析患者而言,年龄、焦虑指数、抑郁指数、Karnofsky活动指数、残肾功能、心血管并发症的发生都可能会影响其生存质量.

Influencing factors of quality of life of elderly patients with peritoneal dialysis

Objective To analysis influencing factors of quality of life of elderly patients with peritoneal dialysis.Method Sixty-three patients aged over 60 years old were treated with continuous ambulatory peritoneal dialysis from 2011 to April 2014 in our hospital.The patients were divided into two groups,one was less than 70 years old and the other was over 70 years old (including 70 years old).The quality of life of the patients was investigated by using SF-36 scale.Results The age ((63.93 + 2.97) vs (73.57 + 3.22) years),Charlson comorbidity index (3.4 + 2.3 vs 5.0 + 3.1),Karnofsky activity index (81.59 + 8.61 vs 71.57 + 16.07),combined with cardiovascular complications (x2 =9.921,P =0.002)between the two groups showed significant differences.There was no significant difference between the two groups in the SF-36 scale of the 8 domains (all P ＞ 0.05).There were statistically significant differences in physical health related quality of life(P =0.031).Pearsons correlation analysis showed that there were positive correlations between total score of SF-36 and Karnofsky activity index(r =0.046,P =0.000),residual renal function(r =0.314,P =0.012),while had negative correlations with anxiety index(r =-0.318,P =0.014) and depression index(r =-0.341,P =0.006).There were negative correlations between physical health related quality of life and age (r =-0.337,P =0.007),combined cardiovascular complications(r =-0.333,P =0.008) and depression index (r =-0.369,P =0.003);while had positive correlations with Karnofsky activity index(r =0.507,P =0.000)and residual renal function(r =0.268,P =0.034).There were negative correlations between mental health related quality of life between anxiety index(r =-0.327,P =0.009),depression index(r =-0.267,P =0.034),while have positive correlations with Karnofsky activity index(r =0.321,P =0.01)and residual renal function (r =0.283,P =0.025).Conclusion For the elderly patients with peritoneal dialysis,age,anxiety index,depression index,Karnofsky activity index,residual renal function,and cardiovascular complications may affect the quality of life.