中国血液净化 ›› 2019, Vol. 18 ›› Issue (09): 626-629.doi: 10.3969/j.issn.1671-4091.2019.09.012

• 临床研究 • 上一篇    下一篇

维持性血液透析患者骨骼肌减少症及影响因素分析

蔡琪1,池向耿1,许敏玲1   

  1. 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 出版日期:2019-09-12 发布日期:2019-09-02
  • 通讯作者: 蔡琪 zfh876432@163.com E-mail:zfh876432@163.com

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

  1.  1Department of Nephrology and Rheumatology, Xiaolan Hospital, Southern Medical University, Guangdong 528415, China
  • Received:2019-01-24 Revised:2019-07-17 Online:2019-09-12 Published:2019-09-02

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

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

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