维持性血液透析患者骨骼肌减少症及影响因素分析

蔡琪

doi:10.3969/j.issn.1671-4091.2019.09.012

中国血液净化 >

2019 , Vol. 18 >Issue 09: 626 - 629

DOI: https://doi.org/10.3969/j.issn.1671-4091.2019.09.012

临床研究

维持性血液透析患者骨骼肌减少症及影响因素分析

蔡琪

展开

1.南方医科大学附属小榄医院肾风湿免疫科

收稿日期: 2019-01-24

修回日期: 2019-07-17

网络出版日期: 2019-09-02

收起

Current status and logistic regression analysis of skeletal muscle loss in maintenance hemodialysis patients

CAI Qi

Expand

1Department of Nephrology and Rheumatology, Xiaolan Hospital, Southern Medical University, Guangdong 528415, China

Received date: 2019-01-24

Revised date: 2019-07-17

Online published: 2019-09-02

Fold

摘要

【摘要】目的探讨维持性血液透析(maintenance hemodialysis，MHD)患者骨骼肌减少症发生情况及相关危险因素。方法选取2016 年1 月～2018 年2 月就诊于南方医科大学附属小榄医院的MHD 患者共180 例作为研究对象，应用改良量化主观评估法评估患者营养状况，分析MHD 患者骨骼肌减少症发生率及影响其发病的相关危险因素。结果180 例MHD 患者中，共59 例确诊患有骨骼肌减少症

(32.78%)，121 未患骨骼肌减少症(67.22%)。2 组间性别、透析时间、超敏C 反应蛋白和营养状况比较差异有统计学意义(χ2=9.752,P=0.002;t=5.515,P＜0.001;t=63.790,P＜0.001;t=10.280,P＜0.001)。多因素Logstic 回归分析结果显示，性别(OR=2.221，95% CI：2.207～12.151，P=0.020)、透析时间(OR=2.191，95% CI：2.185～11.206，P=0.010)、超敏C 反应蛋白(OR=2.174，95% CI：1.235～12.130，P=0.031)和营养状况(OR=3.205，95% CI：1.105～11.207，P=0.015)是影响MHD 患者发生骨骼肌减少症的独立危险因素。结论MHD 患者发生骨骼肌减少症的概率较高，性别、透析时间、超敏C 反应蛋白和营养状况是其独立危险因素，予以针对性预防治疗对降低MHD患者骨骼肌减少症患病率有重要意义。

关键词： 维持性血液透析; 骨骼肌减少症; 危险因素; 发病率

本文引用格式

蔡琪 . 维持性血液透析患者骨骼肌减少症及影响因素分析[J]. 中国血液净化, 2019 , 18(09) : 626 -629 . DOI: 10.3969/j.issn.1671-4091.2019.09.012

Abstract

【Abstract】Objective To investigate the occurrence of skeletal muscle loss and its related risk factors in patients with maintenance hemodialysis (MHD). Methods A total of 180 MHD patients treated in our hospital from January 2016 to February 2018 were selected as the research objects. Their general data and physical indicators were recruited and investigated. The nutritional status was assessed by modified quantitative subjective assessment (MQSGA). The incidence of skeletal muscle loss and its related risk factors in MHD patients were then analyzed. Results Among the 180 MHD patients, 59 (32.78%) were diagnosed with skeletal muscle loss, and 121 were diagnosed without skeletal muscle loss (67.22%). There were statistically significant differences in gender, dialysis time, hs-CRP and nutritional status between the two groups (χ2=9.752, P=0.002; t= 5.515, P＜0.001; t=63.790, P<0.001; t=10.280, P<0.001). Multivariate logistic regression analysis showed that gender (OR=2.221, 95% CI: 2.207～12.151, P=0.020), dialysis time (OR=2.191, 95% CI: 2.185～11.206, P=0.010), hs-CRP (OR=2.174, 95% CI: 1.235～12.130, P=0.031) and nutritional status (OR=3.205, 95% CI:1.105～11.207, P=0.015) were the independent risk factors for skeletal muscle loss in MHD patients. Conclusion The incidence of skeletal muscular loss was higher in MHD patients. Gender, dialysis time, hs-CRP and nutritional status were the independent risk factors for the loss in MHD patients. Therefore, treatments focused on these risk factors should be emphasized to prevent skeletal muscle loss in MHD patients.

Key words： Maintenance hemodialysis; Skeletal muscle loss; Risk factors; Incidence

参考文献

[1]刘丹, 张红梅, 范汝艳, 等. 维持性血液透析患者肌肉减少症调查及影响因素分析[J]. 中国中西医结合肾病杂志, 2018,9(4):16-19.
[2]黄春霞, 许宝珠, 林花兰, 等. 维持性血液透析患者生活质量及危险因素分析[J]. 海南医学, 2017,20(21):109-110.
[3]冯春昕, 陈学勋, 郭民, 等. 不同血液净化方式对维持性血液透析患者骨骼肌营养状况的影响??[J]. 中国中西医结合肾病杂志, 2016,11(11):984-985.
[4]张瑜凌, 王梦婧, 张敏敏, 等. 维持性血液透析患者骨质疏松的危险因素分析[J]. 中华肾脏病杂志, 2016, 32(4):259-263.
[5]刘国香, 韩国锋, 王颖. 维持性血液透析患者口渴以及影响因素分析??[J]. 中国中西医结合肾病杂志, 2016,25(12):1095-1097.
[6]巢志复. 尿毒症透析和肾移植治疗指南[M]. 人民卫生出版社, 2007.
[7]中华医学会骨质疏松和骨矿盐疾病分会. 肌少症共识[J]. 中华骨质疏松和骨矿盐疾病杂志, 2016, 9(3):215-227.
[8]陈琰, 郑淑蓓, 金领微, 等. 维持性血液透析患者镁代谢紊乱与冠状动脉钙化的相关性分析[J]. 中华肾脏病杂志, 2017,16(2):30-34.
[9]Song K K, Zhao D L, Wang Y D, et al. Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China[J]. Chinese Medical Journal, 2017, 130(8):885-891.
[10]张珀璇, 张月君, 陆红雨, 等. 维持性血液透析患者睡眠障碍、相关因素及对生活质量的影响[J]. 中国中西医结合肾病杂志, 2017,8(2):25-28.
[11]叶蕾, 张桂霞, 黄扬扬, 等. 安徽省维持性血液透析患者贫血患病率及血红蛋白达标率的流行病学调查[J]. 中华肾脏病杂志, 2016, 32(4):264-270.
[12]Da J J, Peng H Y, Lin X, et al. [Resting metabolic rate estimated by bioelectrical impedance analysis and its determinants in maintenance hemodialysis patients][J]. China Medical Abstracts (Internal Medicine), 2018, 98(2):912-916.
[13]廖书雯, 刘利利, 赵柯湘,等. 重庆市养老院人群肌肉减少症患病率调查及相关危险因素分析[J]. 国际老年医学杂志, 2018,5(1):22-26.
[14]郑旭冬, 康冬梅. 血清肌肉生长抑制素及超敏C-反应蛋白与老年患者肌肉减少症的相关性[J]. 临床与病理杂志, 2018,8(3):16-19.
[15]乔建歌, 林岑, 郭兆霞, 等. 维持性血液透析患者乐观现状及其影响因素分析[J]. 中国护理管理, 2016, 16(8):1048-1052.
[16]Beberashvili I, Azar A, Sinuani I, et al. Geriatric nutritional risk index, muscle function, quality of life and clinical outcome in hemodialysis patients[J]. Clinical Nutrition, 2016, 35(6):1522-1529.
[17]孙嘉康. 尿毒清联合阿法骨化醇在维持血液透析中对尿毒症患者营养不良的影响[J]. 中国中西医结合肾病杂志, 2017,8(10):20-24.
[18]Wang L J, Wang M Q, Rong H, et al. Effect of Zinc Supplementation on Maintenance Hemodialysis Patients: A Systematic Review and Meta-Analysis of 15 Randomized Controlled Trials:[J]. BioMed Research International,2017,17(4):1-11.
[19]张晓庆, 张晓庆, 张红梅, 等. 维持性血液透析患者症状负担的调查与分析[J]. 中国中西医结合肾病杂志, 2016, 17(9):818-820.
[20]陈佩玲, 龚德华, 徐斌, 等. 维持性血液透析患者心血管钙化进展的相关影响因素分析[J]. 肾脏病与透析肾移植杂志, 2017,16(5):9-13.

Options

文章导航

模态框（Modal）标题

摘要

本文引用格式

Abstract

参考文献