维持性血液透析患者不宁腿综合征的临床特点及相关因素  

Clinical characteristic and correlative factors of maintenance hemodialysis patients with restless legs syndrome

作　　者：杜亭[1] 甘华[1] 陈泽君[2] 夏运风[1] 

机构地区：[1]重庆医科大学附属第一医院肾脏内科,400010 [2]成都市第三人民医院肾内科,610031

出　　处：《中华肾脏病杂志》2017年第3期198-203,共6页Chinese Journal of Nephrology

摘　　要：目的探讨维持性血液透析（maintenance hemodialvsis，MHD）患者中不宁腿综合征（restless legs syndrome，RLS）的发病特点及相关因素，为该病的防治提供科学依据。方法调查并收集本院血液净化中心MHD患者的一般临床资料及生化指标，根据国际不宁腿综合征研究组2012年公布的诊断标准对患者进行RLS的诊断及病情评分，比较RLS与非RLS患者各指标的差异，并通过Logistic回归分析评估MHD患者中与RLS相关的因素。结果307例MHD患者中37例（12．1％）合并RLS。其中73．0％为轻中度RLS，21．6％为重度RLS，5．4％为极重度RLS；83．8％为慢性RLS，仅16．2％为急性或亚急性RLS。RLS与非RLS患者在性别、年龄、原发病构成、透析龄、尿素清除指数（Kt／V）、日均尿量、烟酒史、血红蛋白、肌酐、尿素、尿酸、血钙、血磷、血镁、血钾、全段甲状旁腺素、前白蛋白、白蛋白和碱性磷酸酶等方面差异均无统计学意义（均P〉0．05），但RLS患者日常锻炼频率低于非RLS患者（z=-4．114，P〈0．001）。Logistic回归分析也显示日常锻炼与MHD患者发生RLS呈负相关（B=-2．203，OR=0．111，95％ CI：0．033～0．371，P〈0．001）。结论RLS是MHD患者的常见并发症，以慢性和轻中度患者为主，缺乏规律运动与RLS有关，积极锻炼身体可能是防治该病的科学途径。Objective To explore the prevalence and the correlative factors of restless legs syndrome （RLS） in maintenance hemodialysis （MHD） patients. Methods The basic information and clinical laboratory results of 307 MHD patients were collected. The international RLS study group （IRLSSG） diagnostic criteria were applied to assess the presence and the severity of RLS. Binary logistic analysis was used for exploring correlative factors of RLS. Results The prevalence of RLS was 12.1% in the MHD patients, with 73.0% patients having mild-to-moderate symptoms and 83.8% having chronic RLS. There was no significant difference between MHD patients with and without RLS in age, gender, dialysis age, daily urine, Kt/-V, history of smoking, drinking, hemoglobin, serum creatinine, urea nitrogen, uric acid, calcium, phosphorus, magnesium, potassium, intact parathyroid hormone （iPTH）, prealbumin, albumin and alkaline phosphatase. But the frequency of daily exercise in RLS group is significantly lower than that in non-RLS group （Z=-4.114, P 〈 0.001）. Logistic regression analysis showed that daily exercise was a correlative factor of RLS （B=-2.203, OR=0.111, 95%CI 0.033- 0.371, P 〈 0.001）. Conclusions RLS is a common complication in MHD patients, with chronic state and mild- tomoderate symptoms. RLS is correlated with daily exercise, which may be a scientific approach to treat or prevent this disease.

关 键 词：不宁腿综合征 肾透析 危险因素 运动 

分 类 号：R692[医药卫生—泌尿科学] R741[医药卫生—外科学]