维持性血液透析患者血清磷水平与健康相关生活质量的关系  

Relationship between serum phosphorus levels and health-related quality of life inpatients with maintenance hemodialysis

作　　者：王爽 陈海燕[1] 李博[1] 王博[1] 贾岚 魏芳[1] 姜埃利[1] WANG Shuang;CHEN Hai-yan;LI Bo;WANG Bo;JIA Lan;WEI Fang;JIANG Ai-li(Department of Kidney Disease and Blood Purification,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院肾脏病血液净化科,300211

出　　处：《天津医药》2020年第4期275-278,共4页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81600591)

摘　　要：目的探讨血液透析患者血磷水平与健康相关生活质量(HDQOL)的关系.方法维持性血液透析患者190例,血磷水平>1.78 mmol/L患者作为高磷血症组(n=108),血磷水平≤1.78 mmol/L患者作为非高磷血症组(n=82).记录患者年龄、性别、吸烟史、血液透析通路、每周血液透析次数及合并症等临床资料;记录患者血液透析前各项实验室检查指标:血清钙(Ca2+)、血清磷(P)、血清白蛋白(ALB)、全段甲状旁腺素(iPTH)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、血肌酐(Cr)、血尿酸(UA)、碱性磷酸酶等.比较2组间iPTH、ALB及各指标的差异,多因素Logistic分析与血磷水平相关的影响因素.采用肾脏疾病生活质量-36(KDQOL-36)量表进行生活质量评估,计算KDQOL-36量表中5个亚量表的得分,比较2组间各亚量表的差异,分析血磷水平与生活质量的关系.结果与非高磷血症组相比,高磷血症组患者年龄小,动静脉内瘘比例高,Cr、ALB、iPTH、Ca2+水平高(均P<0.05).多因素Logistic分析结果示,高ALB(OR=1.243,95%CI:1.082~1.427)、高iPTH(OR=1.001,95%CI:1.000~1.002)是高磷血症的危险因素(均P<0.05).高磷血症组各亚量表分数明显低于非高磷血症组(均P<0.05).结论血磷水平影响维持性血液透析患者生活质量,高磷血症组生活质量更差.Objective To investigate the relationship between serum phosphorus levels and health-related quality of life(HDQOL)in hemodialysis patients.Methods A total of 190 patients with maintenance hemodialysis were selected.The patients with blood phosphorus level>1.78 mmol/L were selected as the hyperphosphatemia group(n=108),and the patients with blood phosphorus level≤1.78 mmol/L were selected as the non-hyperphosphatemia group(n=82).Data of age,gender,smoking history,hemodialysis access,frequency/week of hemodialysis treatment,complications and other clinical data were recorded.All the laboratory indicators before hemodialysis were recorded:serum calcium(Ca2+),serum phosphorus(P),serum albumin(ALB),total parathyroid hormone(iPTH),total cholesterol(Tc),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),serum creatinine(Cr),blood uric acid(UA)and alkaline phosphatase.The differences in iPTH,ALB and other indicators were compared between the two groups.Multivariate Logistic analysis was performed to analyze the risk factors related to serum phosphorus level.The questionnaire of Kidney Disease Quality of Life 36(KDQOL-36)was used to evaluate the quality of life,and the scores of five subscales in the KDQOL-36 were calculated.The differences of each subscale were compared between the two groups,and the relationship between blood phosphorus level and quality of life was analyzed.Results Compared with the non-hyperphosphatemia group,the patient age was smaller,the number of arteriovenous internal fistula were more,and the levels of Cr,ALB,iPTH and Ca2+were higher in hyperphosphatemia group(P<0.05).Multivariate Logistic analysis indicated that high ALB(OR=1.243,95%CI:1.082-1.427)and high iPTH(OR=1.001,95%CI:1.000-1.002)were risk factors for hyperphosphatemia(P<0.05).The subscale scores were significantly lower in the hyperphosphatemia group than those of the non-hyperphosphatemia group(P<0.05).Conclusion The serum phosphorus level affects the quality of life of patients

关 键 词：尿毒症 肾透析 生活质量 磷 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学] R459.52[医药卫生—外科学]