维持性血液透析女性肾病患者性功能障碍和生活质量的研究

目的：研究维持性透析女性患者性功能障碍发病情况、表现形式及相关影响因素，同时评估她们的生活质量。方法选择维持性血液透析女性患者50例，总结患者的一般资料（病例组）。通过问卷调查方式调查女性性功能指数FSFI及生活质量（SF-36量表中文版），评价患者性功能状况以及评估患者的生活质量。总结患者实验室检查结果（包括血肌酐、血红蛋白、血浆白蛋白和甲状旁腺激素等）。选取健康成年女性为对照组，行问卷调查。对2组受调查者一般资料和问卷结果进行统计分析。结果病例组性功能障碍发生率为73%，高于对照组的40%。病例组FSFI量表总分平均分数为18.06±8.41低于对照组的26.73±4.63（P<0.01），且各方面得分明显低于对照组。 SF-36量表显示各项指标均低于对照组，P<0.001。多因素logistic分析表明，性功能障碍的发生与患者的年龄、病程、血浆白蛋白、血肌酐、甲状旁腺激素等无关。贫血、甘油三酯（OR=4.514，95% CI：1.119-18.201）、总胆固醇（OR=6.564，95%CI：1.449-29.723）和β受体阻滞剂（OR=10.0，95%CI：1.342-74.511），是维持性血液透析女性患者发生性功能障碍的危险因素，使用r-HuEpo（OR=0.099，95%CI：0.010-0.949）性功能障碍发生的保护性因素。结论维持性透析女性患者性功能障碍发病率高，性功能及生活质量均低于正常人。性功能障碍发生与贫血、血脂异常和应用β受体阻滞剂有关。

Sexual dysfunction and quality of life in female patients with maintenance hemodialysis

Objective To investigate the prevalence, manifestation and related factors of sexual dysfunction in female patients with maintenance hemodialysis,and assesse their life quality. Methods Fifty female patients were recruited into this study from Beijing Daxing Peopleˊs Hospital. By using the questionnaires, all patients were requested to finish two surveys independently, Female Sexual Function Index (FSFI) and SF-36, to assess their sexual function, examine the related factors of sexual dysfunction and evaluate their quality of life. In the meantime, all patientsˊ general clinical data, such as age, weight, etiologies of renal failure, course of disease, medical history and laboratory results, were recorded. An age-matched married control group of 30 volunteers were recruited to this study and finished two questionnaires. All general data and survey responses from the two groups were analyzed. Results The prevalence of sexual dysfunction was higher in the Group Patients than the Group Control (73%vs. 40%). The total scores of FSFI in Group Patients was significantly lower than those of Group Control (18.06±8.41 vs. 26.73±4.63,P< 0.01). Similarly, each aspects of FSFI were significantly lower than those in Group Control, P< 0.01. And according to SF-36 survey response, all dimensions in Group Patinets were much lower in Group Control, P< 0.001. By using of Logsitic regression analysis, it demonstrated that the age, duration, Alb, Scr, PTH and so on was not associated with sexual dysfunction. Anemia, dyslipidemia and using of β-blocker (OR=10.0, 95%CI:1.342-74.511) were risk factors for sexual dysfunction in female patients with maintenance hemodialysis, however, r-HuEpo (OR=0.099; 95%CI:0.010-0.949) was protective factors. Conclusion Sexual dysfunction is common in female patients with maintenance hemodialysis, and their status of sexual function and quality of life are much lower than healthy population. Anemia, dyslipidemia and using of β-blocker are associated with sexual dysfunction.