维持性腹膜透析患者肺淤血与生活质量的关系

发布时间：2018-01-26 00:24

本文关键词： 腹膜透析肺淤血生活质量肺超声慢性肾功能衰竭　出处：《山东医药》2017年22期 　论文类型：期刊论文

【摘要】：目的观察维持性腹膜透析患者肺淤血及生活质量情况,并探讨两者的关系。方法收集105例维持性腹膜透析患者的相关临床资料,应用肺超声显示的B线数目评估肺淤血,采用简明健康调查问卷(SF-36)评估生活质量,计算躯体健康总分(PCS)与精神健康总分(MCS)。采用Spearman相关分析B线数目与PCS、MCS的相关性。按PCS、MCS的中位数值将患者分为高PCS者与低PCS者、高MCS者与低MCS者,并比较两者相关指标的差异,采用logistic回归分析确定生活质量的独立影响因素。结果 105例患者B线数目为4(0,17)条,存在肺淤血52例,PCS为52.8(44.8,59.8)分、MCS为54.5(46.8,60.8)分。B线数目与PCS、MCS呈负相关(r分别为-0.589、-0.464,P均0.01)。与高PCS者相比,低PCS者B线数目、血B型尿钠肽、年龄、糖尿病肾病比例和心脑血管疾病史比例高(P均0.05),血红蛋白、血白蛋白低(P均0.01)。与高MCS者相比,低MCS者B线数目、血B型尿钠肽高(P均0.01),血红蛋白、血白蛋白低(P均0.01)。多因素分析结果显示,B线数目、血红蛋白水平、年龄及心脑血管疾病史是PCS的独立影响因素(P均0.05),但仅前两者是MCS的独立影响因素(P均0.05)。结论维持性腹膜透析患者肺淤血发生率较高且生活质量较低。肺淤血可能是患者生活质量下降的重要原因。
[Abstract]:Objective to observe the pulmonary congestion and quality of life (QOL) in patients with maintenance peritoneal dialysis (MPD) and to explore the relationship between them. Methods the clinical data of 105 patients with maintenance peritoneal dialysis (MPD) were collected. Pulmonary congestion was assessed by the number of B-line ultrasound and quality of life (QOL) was evaluated by SF-36 (a brief health questionnaire). Spearman correlation analysis was used to analyze the correlation between the number of line B and the total score of mental health. The correlation between the number of line B and MCS was analyzed by PCS. The median value of MCS was divided into high PCS patients and low PCS patients, high MCS patients and low MCS patients. Logistic regression analysis was used to determine the independent influencing factors of quality of life. Results the number of B lines in 105 patients was 4 0 / 17 and pulmonary congestion was found in 52 cases. The number of line B was negatively correlated with PCS (P < 0. 589, P < 0. 05). Compared with those with high PCS, the patients with low PCS had the number of B-line, type B urine natriuretic peptide and age. The proportion of diabetic nephropathy and the history of cardio-cerebrovascular disease were both 0.05, hemoglobin and serum albumin were all 0.010.Compared with the high MCS, the number of B-line in the patients with low MCS was lower than that in the patients with high MCS. Urine natriuretic peptide of type B was 0.01g, hemoglobin and serum albumin were 0.010.Multivariate analysis showed the number of B line and the level of hemoglobin. Age and history of cardiovascular and cerebrovascular diseases were independent influencing factors of PCS (P < 0.05). However, only the former two factors are independent factors of MCS (P < 0.05). Conclusion the incidence of pulmonary congestion and quality of life in patients with maintenance peritoneal dialysis are higher and lower, and pulmonary congestion may be an important reason for the decline of quality of life.
【作者单位】：汕头市中心医院;
【基金】：广东省医学科研基金项目(B2016115)
【分类号】：R692.5
【正文快照】： 终末期肾脏病患者尽管可接受维持性透析治疗,但其生活质量仍显著低于普通人群。已有研究发现,维持性透析患者生活质量下降的危险因素有微炎症、营养不良、残余肾功能等,但因研究人群、研究方法、文化、经济等不同而缺乏一致性结论[1~3]。维持性透析患者水钠潴留可引起容量超负

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