维持性血液透析患者不安腿综合征危险因素分析  

The risk factors of restless legs syndrome in maintenance hemodialysis patients

作　　者：曾颖[1] 姜小梅[1] 刘鹏程 高芦燕 施秋泓 姜山[1] 沈华英[1] 方晨 宋锴[1] ZENG Ying;JIANG Xiaomei;LIU Pengcheng;GAO Luyan;SHI Qiuhong;JIANG Shan;SHEN Huaying;FANG Chen;SONG Kai(Department of Nephrology,the Second Affiliated Hospital,Suzhou University,Suzhou 215004,China;不详)

机构地区：[1]苏州大学附属第二医院肾内科,江苏苏州215004 [2]苏州大学附属第二医院内分泌科,江苏苏州215004 [3]苏州大学附属第二医院营养科,江苏苏州215004

出　　处：《实用医学杂志》2022年第1期12-17,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81600607);苏州市科教兴卫项目(编号:KJXW2020017)。

摘　　要：目的分析维持性血液透析(MHD)患者不安腿综合征(RLS)的临床特点及危险因素,评估血液透析滤过吸附(HFR)治疗MHD患者RLS及睡眠质量的临床疗效。方法探讨2020年6月1日至12月31日期间苏州大学附属第二医院MHD患者RLS的相关危险因素。将49例RLS患者随机分为HFR组与血液滤过(HDF)组,观察治疗前及治疗3个月后实验室指标、RLS严重程度及睡眠质量的变化。结果247例血液透析(HD)患者中有49例RLS患者;多因素logistic回归分析显示透析龄≥50个月、高血磷水平、低尿素清除指数、高β_(2)-微球蛋白水平是HD患者发生RLS的独立危险因素(均P<0.05);与治疗前相比,HFR组RLS患者治疗后血β_(2)-微球蛋白水平、RLS及PSQI评分均显著下降,HDF组仅显示RLS评分明显降低;治疗后HFR组β_(2)-微球蛋白水平(t=-2.122,P=0.047)、RLS分值(t=-2.113,P=0.048)较HDF组低。结论长透析龄、高血磷水平、低尿素清除指数、高β_(2)-微球蛋白水平是HD患者发生RLS的独立危险因素。HFR较HDF更有效改善HD患者的RLS症状和睡眠质量。Objective To analyze the clinical characteristics and risk factors of restless legs syndrome(RLS)in maintenance hemodialysis(MHD)patients,and to evaluate the clinical efficacy of hemodiafiltration with endogenous reinfusion(HFR)in the treatment of RLS and sleep quality in MHD patients.Methods The related risk factors of RLS were investigated in the patients who had received MHD in the second affiliated hospital of Suzhou University from June 1,2020 to December 31,2020.Forty-nine patients with RLS were randomly divided into HFR group and hemodiafiltration(HDF)group.The changes in laboratory indexes,RLS severity and sleep quality before and 3 months after treatment were observed.Results Of 247 MHD patients,there were 49 RLS cases.Logistic regression analysis showed that dialysis duration≥50 months,higher phosphorus level,lower urea removal index and higherβ_(2) microglobulin level were the risk factors associated with RLS in HD patients(P<0.05).As compared with the baselines,serumβ_(2)-microglobulin level,RLS scores,and PSQI scores were decreased significantly in HFR group,but only RLS scores decreased significantly in HDF group.Level of serumβ_(2)-microglobulin(t=-2.122,P=0.047)and RLS scores(t=-2.113,P=0.048)in HFR group were lower than those in HDF group.Conclusions Longer dialysis duration,higher serum phosphorus level,lower urea clearance index,and higherβ_(2)-microglobulin level are the independent risk factors for RLS.HFR is more effective in improving sleep quality and symptoms of RLS than HDF.

关 键 词：血液透析滤过吸附 血液透析 不安腿综合征 睡眠质量 

分 类 号：R459.5[医药卫生—治疗学]