中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (04): 264-268.doi: 10.3969/j.issn.1671-4091.2023.04.004

• 临床研究 • 上一篇    下一篇

维持性血液透析患者不安腿综合征的相关危险因素分析

李团结   金 鑫   于泽莺   李 旭   刘加明   

  1. 832000 石河子，1新疆维吾尔自治区石河子市人民医院肾病内科
  • 收稿日期:2022-09-13 修回日期:2023-01-15 出版日期:2023-04-12 发布日期:2023-04-12
  • 通讯作者: 刘加明 E-mail:3109281866@qq.com
  • 基金资助:
    2020年度石河子市人民医院科技计划项目(2020LC27)， 新疆生产建设兵团第八师石河子市科技计划项目(2022RC05)

Analysis of related risk factors for restless legs syndrome in maintenance hemodialysis patients

LI Tuan-jie, JIN Xin, YU Ze-ying, LI Xu   

  1. Department of Nephrology, Shihezi People’s Hospital, Shihezi 832000, China
  • Received:2022-09-13 Revised:2023-01-15 Online:2023-04-12 Published:2023-04-12
  • Contact: 石河子，1新疆维吾尔自治区石河子市人民医院肾病内科 E-mail:3109281866@qq.com

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摘要： 目的 探讨维持性血液透析(maintenance hemodialysis，MHD)患者并发不安腿综合征(restless legs syndrome，RLS)的相关危险因素。方法 选择2021年6月～2022年7月于石河子市人民医院血液透析室的MHD患者，收集患者临床资料，对比分析并发RLS组(A组)与未并发RLS组(B组)患者的一般状况及各项临床参数指标的差异。通过单因素Logistic回归分析及多因素Logistic回归分析各因素与RLS之间的相关性。 结果 共纳入MHD患者169例，未合并RLS组患者103例，合并RLS组患者66例，患病率为39.05%。2组间年龄(t=-2.297，P=0.022)、透析龄(t=-2.938,P=0.003)、血红蛋白(t=-2.205，P=0.027)、血肌酐(t=3.309，P=0.001)、血磷(t=5.732，P=0.002)、血镁(t=-4.070，P＜0.001)、血清铁(t=   -3.545，P＜0.001)、甲状旁腺激素(PTH；t=-4.038，P＜0.001)、β2微球蛋白(β2-MG；t=-3.655，P＜0.001)、铁蛋白(t=-2.291，P=0.022)比较差异有统计学意义。单因素Logistic回归分析显示年龄(OR=0.976，95%CI：0.952～1.000，P=0.046)、透析龄(OR=1.019，95%CI：1.009～1.029，P＜0.001)、血红蛋白(OR=0.976，95%CI：0.957～0.995，P=0.012)、血镁(OR=13.134，95%CI：2.561～67.366，P=0.002)、PTH(OR=1.002，95%CI：1.001～1.003，P=0.001)、β2-MG(OR=1.008，95%CI：1.002～1.013，P=0.010)、铁蛋白(OR=0.998，95%CI：0.996～1.000，P=0.015)与RLS发生有关，多因素Logistic回归分析结果显示长透析龄(β=1.414，P=0.048)、高PTH(β=0.012，P=0.035)、高β2-MG(β=0.013，P=0.014)、低铁蛋白(β=-0.091，P=0.004)是MHD患者发生RLS的独立危险因素。 结论 RLS是MHD患者的常见并发症，透析龄长、PTH及β2-MG增高、铁缺乏可能与维持性血液透析患者RLS的发生有关。

关键词: 维持性血液透析患者, 不安腿综合征, 相关危险因素

Abstract: Objective  To explore the risk factors for restless legs syndrome (RLS) in patients with maintenance hemodialysis (MHD).  Methods  The clinical data of 169 MHD patients treated in the hemodialysis unit of Shihezi People's Hospital from June 2021 to July 2022 were recruited. Clinical parameters were compared between group A (with RLS) and group B (without RLS). The correlations between the clinical data and RLS were analyzed by univariate logistic regression and multivariate logistic regression.  Results  A total of 169 MHD patients were included in this study, and 66 patients had RLS with a RLS prevalence of 39.05%.  Comparisons of clinical data showed that age  (t=-2.297, P=0.022), dialysis age  (t=-2.938, P=0.003), hemoglobin (t=-2.205, P=0.027), serum creatinine (t=3.309, P=0.001), blood phosphorus (t=5.732, P=0.002), blood magnesium (t=-4.070, P＜0.001), serum iron (t=-3.545, P＜0.001), PTH (t=-4.038, P＜0.001), β2-microglobulin (t=-3.655, P＜0.001) and ferritin (t=-2.291, P=0.022) were statistically different between group A and group B. Univariate logistic regression found that age (OR=0.976, 95% CI 0.952~1.000, P=0.046), dialysis age (OR=1.019, 95% CI 1.009~1.029, P<0.001), hemoglobin (OR=0.976, 95% CI 0.957~0.995, P=0.012), blood magnesium (OR=13.134, 95% CI 2.561~67.366, P=0.002), PTH (OR=1.002, 95% CI 1.001~1.003, P=0.001), β2-microglobulin (OR=1.008, 95% CI 1.002~1.013, P=0.010) and ferritin (OR=0.998, 95% CI 0.996~1.000, P=0.015) were associated with the presence of RLS. Multivariate logistic regression showed that longer dialysis age (β=1.414, P=0.048), higher PTH (β=0.012, P=0.035), higher β2-micrglobulin (β=0.013, P=0.014) and lower ferritin (β=-0.091, P=0.004) were the independent risk factors for RLS in MHD patients. Additionally, MHD patients with RLS were more likely to complicate with sleep disorders, anxiety and depression.  Conclusion RLS is a common complication in MHD patients. Longer dialysis, increased PTH and β2-microglobulin, and iron deficiency may relate to the occurrence of RLS in MHD patients. RLS patients are more likely to have sleep disorders, anxiety and depression.

Key words: Maintenance hemodialysis patients, Restless legs syndrome, Risk factor

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