论文部分内容阅读
目的探讨维持性透析患者发生尿毒症脑病(UE)的危险因素及其对生活质量的影响。方法以2009年6月~2013年12月潍坊市二级及以上医院就诊的尿毒症透析患者为研究对象,对比发生UE(42例)及随机选取无尿毒症脑病患者(NUE组,85例)的年龄、性别、吸烟史、饮酒史、原发病、血压情况、血液透析时间、血液透析频率、是否定期血液滤过或血液灌流治疗及实验室检查等情况,以Logistic多因素逐步回归分析确立UE的独立危险因素,进一步关注UE患者的生活质量,应用终末期肾脏疾病透析患者调查表(KDQOL-SFTM1.3)对UE及非UE患者进行SF-36的8个维度及透析相关生存质量(KDTA)维度得分比较。结果 UE组患者年龄、原发病、血液透析频率、是否定期血液滤过或血液灌流、临床依从性、头孢类药物应用、血红蛋白(HGB)、甲状旁腺激素(PTH)、CLU、二氧化碳结合力(CO2CP)与NUE组比较差异有显著性(P<0.05或P<0.01)。Logistic逐步回归分析显示血PTH浓度、原发病(糖尿病)、临床依从性、透析频率、HGB、头孢类药物应用史、CO2CP是UE的独立危险因素,风险比值和95%可信限分别为0.938~6.256,2.334~3.376,0.827~2.862,1.873~2.593,1.182~4.048,1.253~3.741,1.435~2.534.UE患者SF-36的8个维度得分及KDTA维度得分均较低。结论血PTH浓度、原发病(糖尿病)、临床依从性、透析频率、HGB、头孢类药物应用史、CO2CP是UE的独立危险因素,UE患者生活质量明显降低。
Objective To investigate the risk factors of uremic encephalopathy (UE) in maintenance dialysis patients and its impact on quality of life. Methods A total of 42 patients with uremia and 85 patients with uremic encephalopathy were enrolled in this study from June 2009 to December 2013 in Weifang Second and above hospitals. Age, sex, smoking history, drinking history, primary disease, blood pressure, hemodialysis time, hemodialysis frequency, whether regular hemofiltration or hemoperfusion therapy and laboratory tests, etc., by stepwise logistic regression analysis To further investigate the quality of life of patients with UE, the 8 dimensions of SF-36 and dialysis-related quality of life (KDQOL-SFTM1.3) were used in patients with UE and non- KDTA) dimension score comparison. Results The age, primary disease, hemodialysis frequency, periodic hemofiltration or hemoperfusion, clinical compliance, cephalosporin use, hemoglobin (HGB), parathyroid hormone (PTH), CLU, carbon dioxide binding capacity (CO2CP) compared with the NUE group (P <0.05 or P <0.01). Logistic regression analysis showed that blood PTH concentration, primary disease (diabetes), clinical compliance, dialysis frequency, HGB, history of cephalosporin use and CO2CP were independent risk factors for UE. The hazard ratios and 95% confidence limits were 0.938 ~ 6.256,2.334 ~ 3.376,0.827 ~ 2.862,1.873 ~ 2.593,1.182 ~ 4.048,1.253 ~ 3.741,1.435 ~ 2.534, respectively. The scores of 8 dimensions and KDTA of SF-36 in UE patients were all lower. Conclusions Blood PTH concentration, primary disease (diabetes), clinical compliance, dialysis frequency, HGB, cephalosporin application history, CO2CP are independent risk factors of UE, and the quality of life of UE patients is obviously decreased.