腹膜透析患者皮下注射促红细胞生成素依从性的影响因素分析  

Analysis of related factors affecting the compliance of subcutaneous erythropoietin in peritoneal dialysis patients

作　　者：于晓丽[1] 林建雄[1] 易春燕[1] 陈崴[1] 阳晓[1] YU Xiao-li;LIN Jian-xiong;YI Chun-yan;CHEN Wei;YANG Xiao(Department of Nephrology,the First Afiliated Hospital,Sun Yat-sen University,NHC Key Laboratory of Clinical Nephrology(Sun Yat-Sen University)and Guangdong Provincial Key Laboratory of Nephrology,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院肾内科、国家卫生健康委员会肾脏病临床研究重点实验室(中山大学)、广东省肾脏病重点实验室,广东广州510080

出　　处：《中国实用内科杂志》2023年第2期132-136,147,共6页Chinese Journal of Practical Internal Medicine

基　　金：广东省肾脏病重点实验室(2020B1212060028)。

摘　　要：目的在健康信念模式指导下探讨腹膜透析(PD)患者促红细胞生成素(EPO)注射依从性现状及相关影响因素。方法纳入2021年1月至6月在中山大学附属第一医院规律随访并注射EPO的PD患者244例。将EPO不依从定义为使用少于90%的处方剂量或报告漏注射的情况。根据依从性情况分为依从组与不依从组,比较组间差异,并用logistic回归分析EPO治疗不依从的影响因素。结果患者年龄(47.1±12.4)岁,男性占46.7%,中位透析月33.3(11.6,73.9)个月。EPO不依从率为59.8%,血红蛋白达标率为63.5%。多因素logistic分析发现短透析月、注射疼痛、低药物效力满意度(P<0.05)是EPO不依从的危险因素。结论PD患者EPO治疗存在达标率低、依从性差的现象。短透析月、注射疼痛、低药物效力满意度是EPO不依从的危险因素。Objective To analyze the current situation of subcutaneous erythropoietin(EPO)compliance and associated risk factors in patients with peritoneal dialysis(PD)by using the Health Belief Model.Methods A total of 244 PD patients who were treated with EPO and regularly followed up in the First Affiliated Hospital of Sun Yat-sen University from January to June 2021 were recruited.Noncompliance was defined as less than 90%use of the prescribed dose or missed injections on the questionnaire.Patients were divided into compliance and non-compliance group and the differences between the two groups were compared.Multivariate logistic regression was used to identify risk factors of non-compliance of EPO.Results The mean age of the enrolled patients was(47.1±12.4)years,46.7%were male,and the median vintage of PD was 33.3(11.6,73.9)months.The rate of non-compliance to EPO was 59.8%and 63.5%of the patients reached the targeted hemoglobin level.Multivariate Logistic regression analysis showed that shorter PD vintage,injection pain,low satisfaction with EPO efficacy were risk factors of non-compliance of EPO(all P<0.05).Conclusion PD patients with EPO treatment in our center have low targeted hemoglobin level and compliance rate.Shorter PD vintage,injection pain,lower satisfaction with efficacy are risk factors for the non-compliance to EPO.

关 键 词：腹膜透析 促红细胞生成素 依从性 

分 类 号：R459.5[医药卫生—治疗学]