维持性血液透析患者生活质量评价及影响因素分析

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.

Evaluation of quality of life and its influencing factors in maintenance hemodialysis patients

Objective To investigate the quality of life and its influencing factors in patients of maintenance he-modialysis (MHD). Methods A total of 102 patients of MHD, who admitted to Department of Nephrology of the Affili-ated 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 con-trol group (P<0.05). Single factor analysis showed the SF-36 score in MHD patients with age≥60 years old, female, sin-gle, 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 indepen-dent 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 af-fecting the quality of life.