中国血液净化

›› 2006, Vol. 5 ›› Issue (8): 422-425.

• 论著 • 上一篇    下一篇

不安腿综合征对血液透析患者生活质量及睡眠质量影响的研究

刘 莉1 崔太根1 王 梅   

  1. 100034 北京，1北京大学第一医院肾内科 100044 北京，2北京大学人民医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-08-12 发布日期:2006-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-08-12 Published:2006-08-12

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摘要： 目的 了解北京大学第一医院肾内科血液透析中心不安腿综合征(RLS)的患病率，对其严重程度进行量化评分，并初步探讨RLS的影响因素及其严重程度对睡眠质量和生活质量的影响。方法 以我院108例因慢性肾功能不全进行维持性血液透析治疗的患者为研究对象。不安腿综合征的诊断采用国际不安腿综合征研究小组制定的不安腿诊断标准量表。以匹兹堡睡眠质量指数（PSQI）和简明健康状况调查表（SF-36量表）分别进行生活质量和睡眠质量评估。记录患者的透析方案、生化指标及治疗用药等资料，探讨RLS的影响因素。随机抽取一组不伴RLS患者为对照组，进一步评估RLS对睡眠质量和生活质量的影响。结果 ①我院血液透析中心RLS患者共14例，男性7例，女性7例，其患病率为13%。②RLS患者与不伴RLS患者在年龄、性别、透析龄、每周透析时间，尿素清除率，透析前血肌酐、尿素氮、血红蛋白、红细胞压积、铁蛋白、转铁蛋白饱和度、钙、磷、钙磷乘积、全段甲状旁腺激素（iPTH）等生化指标，以及是否使用铁剂、钙离子拮抗剂等治疗方面均未发现差异。③RLS组PSQI为(10.86±5.48)，不伴RLS组PSQI为(4.93±4.73)，两者间差异具有显著性（P＝0.005）。但RLS严重程度仅与主观睡眠质量具有相关性（P＜0.05），与SF-36分值呈负相关（r＝-0.661，P＝0.01）。结论 我中心维持性血液透析患者中RLS患病率为13%。RLS患者的睡眠较差，主要表现在主观睡眠质量、睡眠时间、习惯睡眠效应、日间功能等方面。同时维持性血液透析RLS患者的RLS严重程度影响到患病者的生活质量。

关键词: 不安腿综合征, 维持性血液透析, 生活质量, 睡眠质量

Abstract:

Objective The aim of the study was to evaluate the prevalence of restless legs syndreme (RLS) in our hemodialysis center, to analyze the potential influencing factors of RLS, and to investigate the relationship between RLS and the quality of life or sleep disturbances. Methods The RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). The subjects' quality of sleep and life were assessed by the Pittsburgh Sleep Quality Index (PSQI) and SF-36, respectively. The following data were collected: age, gender, duration of HD, times of HD weekly, Kt/V, pre-dialysis blood concentrations of creatinine, hemoglobin, hematocrit, ferritin, transferrin saturation, total calcium, phosphorus, Ca×P product, and intact parathyroid hormone,t test and 2 test were performed on above factors between patients with RLS and those without RLS. Control group of HD patients without RLS was randomly selected to evaluate the influence of RLS on the quality of life and sleep in maintenance HD patients. Results All the 108 HD patients in our center were enrolled in the study. RLS was found in 13.0% (7 men, 7 women) of HD patients. There were no significant differences in duration of HD, times of HD weekly or other biochemical parameters between patients with RLS and those without RLS. In the case-control study, PSQI of RLS group was higher than PSQI of without-RLS group (10.86+/-5.48 vs 4.93+/-4.73, P=0.005). Moreover, the RLS severity was correlated with the subjective sleep quality (r＝0.576, P＜0.05) and the SF-36 score in RLS group (r＝-0.661，P＝0.01). Conclusion The prevalence of RLS of HD patients from our center was 13.0%. Poor sleep quality was found in RLS patients, mainly in subjective sleep quality, sleep duration, habitual sleep efficiency and daytime dysfunction. The RLS severity influenced the quality of life.

Key words: The Quality of life, the Quality of sleep, Maintenance hemodialysis

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