血液透析患者不宁腿综合征相关因素分析  

Association of restless legs syndrome with malnutrition,inflammation and sleep quality in hemodialysis patients

作　　者：黄华星[1] 沈良兰[1] 张芬[1] 王琛[1] 房星星[1] 陈冬梅[1] HUANG Hua-xing SHEN Liang-lan ZHANG Fen WANG Chen FANG Xing-xing CHEN Dong-mei(Department of Nephropathy, the Second Affiliated Hospital of Nantong Uni- versity, Nantong 226001, China)

机构地区：[1]南通大学第二附属医院肾内科,南通226001

出　　处：《临床肾脏病杂志》2017年第4期230-233,共4页Journal Of Clinical Nephrology

摘　　要：目的观察血液透析患者并发不宁腿综合征(restless legs syndrome,RLS)的情况,分析RLS的发生率、严重程度与患者营养不良、炎症、睡眠质量的关系,为临床防治RLS提供依据。方法选择2015年1月至2015年12月在南通大学第二附属医院住院或门诊就诊的行维持性血液透析治疗的慢性肾脏病患者119例,其中男67例,女52例,年龄25~78岁,平均年龄(60.9±13.9)岁,采集所有患者体质量指数、血尿素氮、血肌酐、血红蛋白、总铁结合力、铁蛋白、血尿酸、血磷、血钙、甲状旁腺素、C反应蛋白、总蛋白、白蛋白、总胆固醇、三酰甘油。以营养不良-炎症评分系统(malnutrition inflammation score,MIS)反映营养和炎症水平,采用匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)评估患者睡眠。使用单因素逻辑回归分析对相关的因素进行分析。结果入组的119例患者中并发RLS的有21例,RLS的发生率是17.6%。RLS患者和非RLS患者相比,MIS评分无统计学差异(P>0.05);和非RLS患者相比,RLS患者的PSQI评分明显升高(P<0.05)。根据回归分析结果,RLS的严重程度和PSQI(r=0.445,P=0.006)、白细胞(r=0.427,P=0.008)、C反应蛋白(r=0.418,P=0.010)呈正相关,但和MIS无相关性(r=0.179,P=0.28)。结论血液透析患者RLS的发生与睡眠质量相关,而且它的严重程度和PSQI及部分炎症指标呈正相关。Objective To observe the situation of maintenance hemodialysis （MHD） for chronic kidney disease （CKD） in patients with restless legs syndrome （RLS）, analyze the incidence and severi- ty of RLS and their relationship with malnutrition, inflammation and sleep quality, and to provide evi- dence for the prevention and treatment of RLS. Methods The 119 MHD patients were enrolled from the out-patient and in-patient, including 67 men and 52 women with age ranging from 25 to 78 years old （mean 60. 9 ＋ 13. 9 years）. The basic clinical characteristics and laboratory data were collected. RLS was diagnosed according to the criteria from International Restless Legs Syndrome Study Group. Malnutrition-inflammation （MIS） and Pittsburgh Sleep Quality Index （PSQI） were evaluated. Single factor Logistic regression analysis was used to analyze the related factors. Results All of the 119 pa- tients were enrolled in the study, and there were 21 cases of RLS. MIS of the patients with or without RLS was similar （P〉0. 05）. The PSQIS score in RLS group were significantly increased （P〈0. 05）. The severity of RLS was positively correlated with PSQI （r = 0. 445, P = 0. 006）, white blood cells （r = 0. 427, P = 0. 008）, and C reactive protein （CRP） （r= 0. 418, P = 0. 010）. There was no correla- tion between RLS and MIS （r = 0. 179, P = 0. 28）. Conclusions The RLS in hernodialysis patients with CKD is related to the quality of sleep, and its severity was positively correlated with PSQI and some inflammatory parameters.

关 键 词：不宁腿综合征 血液透析 营养不良 炎症 睡眠质量 

分 类 号：R459.5[医药卫生—治疗学]