维持性血液透析患者生活质量及其影响因素分析  

Assessment of quality of life and its influence factors in maintenance hemodialysis patients

作　　者：文雯[1] 夏运风[1] 甘华[1] 

机构地区：[1]重庆医科大学附属第一医院肾内科,400016

出　　处：《中华肾脏病杂志》2015年第4期283-288,共6页Chinese Journal of Nephrology

摘　　要：目的了解维持性血液透析（MHD）患者的生活质量及其影响因素，为提高患者生活质量提供理论指导。方法选择本院血液净化中心257例MHD患者，收集患者临床资料并应用改良定量主观整体评估法（MQSGA）评估其营养状态，采用SF-36量表评估其生活质量，通过单因素方差分析、Pearson相关分析和多元线性逐步回归分析了解影响患者生活质量的因素。结果MHD患者SF-36量表各维度得分均低于既往报道的一般人群，其生理健康评分随年龄增长呈下降趋势，但心理健康评分以41～60岁组患者较高。原发病为糖尿病肾病的患者及中、重度营养不良的患者其SF-36评分相对较低，而高学历及高收入患者的SF-36量表评分相对较高。回归分析结果显示，MHD患者生理健康评分和SF-36总分与总胆固醇、BMI呈正相关，与肺动脉收缩压、原发病为糖尿病肾病、MQSGA评分呈负相关；患者心理健康评分与家庭人均月收入呈正相关，与MQSGA评分呈负相关（均P〈0．05）。结论MHD患者生活质量明显降低，原发病和营养状态可能是影响其生活质量的主要因素，年龄、文化程度、家庭收入和肺动脉收缩压对患者生活质量也具有一定影响。Objective To investigate the quality of life （QOL） of maintenance hemodialysis （MHD） patients and its influencing factors. Methods A total of 257 MHD patients in our hospital were recruited in this study. Clinical data of the patients were collected, and the QOL was assessed by MOS 36 item short form health survey（SF-36）. Nutritional status of patients was evaluated by modified quantitative subjective global assessment （MQSGA）. Univariate analysis of variance, pearson correlation analysis and multiple linear stepwise regression analysis were performed to determine the effect of related factors on QOL scores. Results The scores of all scales of SF- 36 evaluation in MI-ID patients were relatively lower than that of general population as reported before. Their physiological component summary （PCS） score decreased gradually as age grew, nevertheless, the mental component summary （MCS） score was highest in the group aged 41- 60. The score was lower in patients with moderate to severe malnutrition or diabetic nephropathy when compared with other patients. Univariate analysis of variance also revealed that high SF-36 scores associated with higher education or income. Multivariate analysis indicated that PCS score and total SF-36 score of MHD patients were positively correlated with body mass index （BMI） and cholesterol, but negatively correlated with diabetic nephropathy, pulmonary artery systolic pressure and MQSGA score （all P 〈 0.05）. There was positive correlation between MCS score and income, yet negative correlation between MCS score and MQSGA score （all P 〈 0.05）. Conclusion MHD patients had relatively poor QOL. Primary diseases and nutritional status were probably the main influencing factors. Age, educated level, family income and pulmonary artery systolic pressure might also have effects on their QOL.

关 键 词：血液透析 生活质量 SF-36量表 改良定量主观整体评估法 

分 类 号：R692.5[医药卫生—泌尿科学]