慢性肾脏病患者生活质量对肾功能进展的影响  

Impact of quality of life in patients with chronic kidney disease on the progression of renal function

作　　者：肖晓芬[1] 韩四萍[2] 王小琴[2] 

机构地区：[1]湖北中医药大学2013级硕士研究生,武汉430061 [2]湖北省中医院肾内科

出　　处：《临床肾脏病杂志》2015年第3期137-141,共5页Journal Of Clinical Nephrology

基　　金：武汉市科技局软科学项目(No.201141333440-1)

摘　　要：目的了解慢性肾脏病（chronic kidney disease，CKD）2～4期未透析患者生活质量状况，并探讨其对肾功能进展的影响。方法对湖北省中医院肾病科门诊的138例CKD2～4期患者规律随访2年并定期进行生活质量评估及血肌酐测量，同时记录性别、年龄、病程、原发病、血压、身高、体质量，计算体质量指数；比较CKD2～4期患者生活质量差异。将138例患者根据肾功能进展情况分为肾功能进展组与肾功能无进展组，比较2组基本情况及生活质量差异，采用非条件Logistic回归分析，分析肾功能进展的危险因素。结果①CKD2～4期患者生活质量10个维度得分比较，CKD4期组均较CKD3期组、CKD2期组低，且在症状影响、肾病影响、身体功能、社会功能、精力、体力方面差异有统计学意义（P〈0．05）。②肾功能进展组与肾功能无进展组比较，肾功能进展组体质量指数低于肾功能无进展组，差异有统计学意义（P〈0．05）；生活质量10个维度中，肾功能进展组得分低于肾功能无进展组，在症状影响、肾病影响、肾病负担、身体功能、情感状况、社会情感、精力、体力方面差异有统计学意义（P〈0．05）。③肾功能进展危险因素分析，体质量指数、症状影响、身体功能、情感状况为肾功能进展的危险因素。结论CKD患者的生活质量随着肾小球滤过率下降而降低，且肾功能进展者生活质量较差。生活质量中症状影响、身体功能及情感状况是肾功能进展的危险因素，提示CKD患者生活质量下降加速病情进展的恶性循环，关注其生活质量十分必要。Objective To understand the quality of life in patients with chronic kidney disease （CKD）at stages 2, 3 and 4 without renal replacement treatment, and to identify its influence on the progress of renal function. Methods We regularly assessed the quality of life in 138 patients wiht CKD at stages 2, 3 and 4 from Hubei Provincial Hospital of Traditional Chinese Medicine and the serum creatinine levels were determined in two years. The gender, age, course of the disease, primary dis- ease, blood pressure, height and weight recorded in all patients, and the body mass index（ BMI） was calculated. The quality of life among the three stages was compared. All patients were divided into pro- gressive renal function group and non-progressive renal function group. The basic information and qual- ity of life were compared, and the risk factors for progression of renal function were analyzed by non- conditional Logistic regression analysis. Results （①The scores of all 10 dimensions on quality of life in CKD stage 4 group were lower than those in CKD stage 3 and CKD stage 2 groups, and there was sig- nificant difference in influence of symptoms, influence of kidney disease, physical function, social function, and physical energy（P〈0. 05）. ②The BMI was lower in the progression group than in the non-progression group（P〈0. 05）. On the 10 dimensions of quality of life, the scores in the progression group were lower than in the non-progression group. There was significant difference in influence of symptoms, influence of kidney disease, kidney disease burden, physical function, emotional status, socioemotion, and physical energy（P〈0. 05）. ③BMI, influence of symptoms, physical function, and emotional status were risk factors for progression of renal function. Conclusions Quality of life in pa- tients with CKD was declined along with the reduction of glomerular filtration rate, and that in pa- tients with renal progress is worse. Influence of symptoms, physical function and emotional status are the ri

关 键 词：慢性肾脏病 生活质量 危险因素 

分 类 号：R692[医药卫生—泌尿科学]