维持性血液透析患者生理功能和生活质量的横断面调查及影响因素分析  

Cross-sectional study of physiological function and quality of life and their influence factors in maintenance hemodialysis patients

作　　者：张兰[1] 孙超[1] 程艳娇[1] 马迎春[1] ZHANG Lan;SUN Chao;CHENG Yan-jiao;MA Ying-chun(Department of Nephrology,Beijing Bo'ai Hospital,China Rehabilitation Research Center,School of Rehabilitation Medicine,Capital Medical University,Beijing 100068,China)

机构地区：[1]首都医科大学康复医学院中国康复研究中心北京博爱医院肾内科,北京100068

出　　处：《中国血液净化》2019年第4期237-241,共5页Chinese Journal of Blood Purification

基　　金：中国康复研究中心课题2017ZX--05

摘　　要：目的评估维持性血液透析(maintenance hemodialysis,MHD)患者生理功能、生活质量评分情况,并分析其相关影响因素。方法选择中国康复研究中心北京博爱医院规律血液透析超过3个月的MHD患者123例,调查其生理功能(日常生活活动能力、握力、6分钟步行试验)及SF-36生活质量评分。结果①生理功能:能独立完成所有日常生活活动项目的患者仅35人(28.5%)。MHD患者普遍存在握力下降(20.8±9.1)kg。多元线性回归结果显示,MHD患者性别、年龄、透析龄、血清白蛋白水平与MHD患者握力下降密切相关(标准化系数β值分别为0.283、-0.772、-0.096、1.544,P值分别为<0.001、<0.001、0.022、<0.001)。MHD患者6分钟步行试验(six-minute walking test,6MWT)为(413.6±111.3)m,显著低于普通成年个体。多元线性回归结果显示,MHD患者年龄每增加10岁,6MWT下降58.4m;血白蛋白每增加10g/L,6MWT增加191.8m。②生活质量评分:MHD患者普遍存在生活质量评分的下降,机体功能44.92±11.11、工作能力59.7±35.73、躯体疼痛74.38±19.47、一般健康状况48.38±11.41、活力57.71±10.01、社会功能66.56±21.94、情感角色41.38±35.96、精神健康36.87±7.81、SF-36总分53.91±6.30。结论 MHD患者普遍伴随着生理功能障碍以及生活质量评分的下降。早期关注MHD患者的生理功能下降,及时采取康复干预,对延缓MHD患者的功能障碍,提高生活质量评分具有重要的临床实际意义。Objective To evaluate the situation of physiological function and quality of life(QOL)as well as their related factors in maintenance hemodialysis(MHD)patients.Methods A total of 123 MHD patients with regular hemodialysis for more than three months in Beijing Bo'ai Hospital of China Rehabilitation Research Center were enrolled to investigate physiological function(activity of daily living,grip strength,6-minute walking test)and quality of life.Results①Physiological function:Only 35 patients(28.5%)could independently complete all activities of daily living.There was a general decrease in grip strength in MHD patients(20.8+9.1kg).Multivariate linear regression analysis showed that sex,age,dialysis age,serum albumin level were closely related to the decrease of grip strength in MHD patients(standardized coefficientβ=0.283,-0.772,-0.096 and 1.544 respectively;P<0.001,<0.001,0.022 and<0.001 respectively).The 6-minute walking test(6MWT)was 413.6+111.3m,significantly lower than that in healthy individuals.Multivariate linear regression analysis showed that the 6MWT decreased by 58.4m after the increase of 10 years of age,and the 6MWT increased by 191.8m in the increase of serum albumin 10g/L in MHD patients.②Quality of life score:The decrease of quality of life score was detected in most MHD patients:body function 44.92+11.11,work ability 59.7+35.73,body pain 74.38+19.47,general health 48.38+11.41,vitality 57.71+10.01,social function 66.56+21.94,emotional role 41.38+35.96,mental health 36.87+7.81,and total SF-36 53.91+6.30.Conclusion Most MHD patients are accompanied by physiological dysfunction and lower quality of life.Early awareness of the dysfunctions and early rehabilitation intervention are of clinical significance to alleviate the dysfunctions and the lower quality of life in MHD patients.

关 键 词：血液透析 功能障碍 生理功能 生活质量 

分 类 号：R318.16[医药卫生—生物医学工程]