非透析慢性肾脏病贫血患者的生存质量评估

发布时间：2019-06-07 10:16

【摘要】：目的:通过研究非透析慢性肾脏病患者贫血对生存质量的影响因素,探讨纠正患者的贫血状况是否可以改善患者的躯体症状以及患者的心理健康状态,从而提高患者的生存质量。方法:入选2015年10月至2016年2月吉林大学第二医院诊断为慢性肾脏病且为非透析的患者79例,记录年龄、性别、原发病、生化指标(如血红蛋白浓度、血清铁浓度、转铁蛋白饱和度、钙、磷、PTH、肌酐等)临床资料,并需要受试者完成KDQOLTM-SF中简化的SF-36量表调查问卷,SF-36量表中包含健康相关生存质量的8个维度:生理功能、生理职能、情感职能、社会功能、躯体疼痛、精力、一般健康状态、精神健康,通过让受试者完成每个维度相关测评后计算各个维度分数,最后应用统计学分析方法综合分析数据以评估患者生存质量。结果:1.入选的79例患者中,男性42例(占53%),女性37例(占47%),男女比例约为:1.14:1。根据年龄段可划分为青年组(45岁),中年组(45~64岁),和老年组(≥65岁),平均年龄62.2±15.3岁。其中青年组13例(占16.4%),中年组29例(占36.6%),老年组37例(占47%)。2.从肾脏病发病原因看,糖尿病性肾病居多(占44.3%),其次为原发肾脏疾病(如慢性肾小球肾炎、慢性间质性肾炎、肾病综合征等)。根据受试者血红蛋白情况,把血红蛋白正常的患者作为对照组;贫血的患者按实际贫血程度划分为2组:轻度贫血组(90g/LHb110g/L),中度贫血组(60g/LHb90g/L)。3.分析3组患者SF-36健康调查量表分数,从对照组到中度贫血组得分逐渐减少,其中对照组与中度贫血组对比差异有统计学意义(P0.05)。从总体上看,3组SF-36各个生存质量相关维度中精神健康状态得分偏高,其次为躯体疼痛和社会功能,而3组中生理职能、一般健康状态、精力等维度得分偏低。4.将3组患者SF-36得分两两配对多重对比分析,结果为:对照组与轻度贫血组,轻度贫血组与中度贫血组,以上配对组的P值为0.047,小于0.05,差异有统计学意义;对照组与轻度贫血组,对照组与中度贫血组,以上配对组的P值为0.315,差异无显著统计学意义;对照组与中度贫血组,轻度贫血组与中度贫血组,以上配对组的P值为0.293,差异无显著性统计学意义。5.分析血红蛋白与SF-36各个维度相关性,结果表明受试者SF-36各个维度得分与血红蛋白水平呈正相关,P值均小于0.01。结论:1.CKD患者出现贫血并发症时最先容易影响到生存质量中生理职能、一般健康状态、精力等维度,对精神健康、躯体疼痛和社会功能影响较小。2.CKD贫血患者生存质量受贫血程度影响,与血红蛋白水平呈正相关。3.CKD贫血患者当贫血程度达到中度时,开始对生存质量有显著影响。
[Abstract]:Objective: to study the influencing factors of anemia on quality of life in patients with non-dialysis chronic kidney disease, and to explore whether correcting anemia can improve the physical symptoms and mental health of patients. In order to improve the quality of life of patients. Methods: from October 2015 to February 2016, 79 patients with chronic kidney disease and non-dialysis were enrolled in the second Hospital of Jilin University. Age, sex, primary disease and biochemical indexes (such as hemoglobin concentration, serum iron concentration) were recorded. Clinical data of transferrin saturation, calcium, phosphorus, PTH, creatine, etc., and subjects were required to complete the simplified SF- 36 questionnaire in KDQOLTM-SF. SF- 36 scale contained eight dimensions of health-related quality of life: physiological function. Physical function, emotional function, social function, physical pain, energy, general health status, mental health, by allowing the subjects to complete the relevant evaluation of each dimension to calculate the scores of each dimension, Finally, the statistical analysis method was used to evaluate the quality of life of the patients. Result: 1. Of the 79 patients selected, 42 were males (53%) and 37 were females (47%). The ratio of male to female was about 1.14%. According to the age group, it can be divided into youth group (45 years old), middle age group (45 鈮，

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