中国维持性血液透析患者衰弱患病率及影响因素的Meta分析  

Prevalence and Influencing Factors of Frailty in Maintenance Hemodialysis Patients in China:a Meta-analysis

作　　者：王晓霞 曹学华[2] 李艳[3] 熊浪宇 胡婉琴 向凤 贾钰 WANG Xiaoxia;CAO Xuehua;LI Yan;XIONG Langyu;HU Wanqin;XIANG Feng;JIA Yu(School of Nursing,Chengdu University of TCM,Chengdu 610075,China;Department of Gynecology,Sichuan Provincial People's Hospital,Chengdu 610072,China;Department of Nephrology,Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]成都中医药大学护理学院,四川省成都市610075 [2]四川省人民医院妇科,四川省成都市610072 [3]四川省人民医院肾内科,四川省成都市610072

出　　处：《中国全科医学》2024年第20期2534-2544,共11页Chinese General Practice

基　　金：成都市科技项目(2022-YF05-01595-SN)。

摘　　要：背景 慢性肾脏疾病成为全球关注的重点问题,而我国肾病患病率为全球最高。约有89.5%的患者需要进行血液透析。近年来,维持性血液透析(MHD)患者衰弱的患病率明显上升,严重影响了患者的生活质量及预后。目的 通过Meta分析探讨我国MHD患者衰弱患病率及影响因素。方法 系统检索中国知网、维普网、中国生物医学文献数据库、万方数据知识服务平台、Web of Science、PubMed、Cochrane Library、Embase、CINAHL数据库中有关中国MHD患者衰弱患病率及影响因素的横断面研究和队列研究,检索时限为建库至2023年7月。由2名研究者独立进行文献筛选、资料提取及质量评价,使用Stata 15.0软件进行Meta分析。结果 纳入32篇文献,包括6 746例患者,其中衰弱患者2 566例,涉及影响因素37项。Meta分析结果显示:我国MHD患者衰弱患病率为37.4%(95%CI=30.3%~44.5%)。年龄(OR=1.09,95%CI=1.06~1.13)、年龄>60岁(OR=3.81,95%CI=2.31~6.30)、女性(OR=2.13,95%CI=1.47~3.08)、独居(OR=2.42,95%CI=1.22~4.80)、睡眠(OR=1.28,95%CI=1.08~1.50)、抑郁(OR=1.97,95%CI=1.26~3.08)、透析龄(OR=3.25,95%CI=1.82~5.79)、社会支持(低水平)(OR=1.99,95%CI=1.39~2.86)、合并并发症(OR=1.79,95%CI=1.40~2.30)、营养不良(OR=1.17,95%CI=1.07~1.28)、Charlson合并症指数(CCI)(OR=1.32,95%CI=1.01~1.71)、C反应蛋白(CRP)(OR=1.15,95%CI=1.09~1.21)、血红蛋白(Hb)<110 g/L(OR=2.70,95%CI=1.67~4.36)、合并糖尿病(OR=2.16,95%CI=1.48~3.16)、合并脑血管疾病(OR=2.66,95%CI=1.85~3.82)、合并冠心病(OR=3.50,95%CI=2.15~5.70)是MHD衰弱的危险因素(P<0.05);高经济收入(OR=0.02,95%CI=0.01~0.14)、社会支持(高水平)(OR=0.86,95%CI=0.76~0.97)、营养良好(OR=0.47,95%CI=0.26~0.85)、日常生活能力(ADL)(OR=0.80,95%CI=0.70~0.91)、血清白蛋白(ALB)(OR=0.84,95%CI=0.77~0.91)、Hb≥110 g/L(OR=0.70,95%CI=0.54~0.90)、25-羟维生素D[25-(OH)VD](OR=0.69,95%CI=0.49~0.98)是MHD衰弱的保护因素(P<0.05)。结论 我国MHD患者衰弱患�Background Chronic kidney disease has become a major global concern,and the prevalence of kidney disease in China is the highest in the world.About 89.5% of patients require hemodialysis.In recent years,the prevalence of frailty in maintenance hemodialysis(MHD)patients has risen significantly,seriously affecting the quality of life and prognosis of patients.Objective To explore the prevalence of frailty and the influencing factors of maintenance hemodialysis patients in China through Meta-analysis.Methods Cross-sectional and cohort studies on the prevalence and influencing factors of frailty in Chinese MHD patients were systematically searched in CNKI,VIP,CBM,Wanfang Data,Web of Science,PubMed,Cochrane Library,Embase,and CINAHL databases.The search deadline was from the respective databases to July 2023.Literature screening,data extraction and quality assessment were performed independently by two researchers.Stata 15.0 was used for meta-analysis.Results Thirty-two papers were included,and including 6 746 patients,among which 2 566 experienced frailty,involving 37 influencing factors.Meta-analysis showed that the prevalence of frailty in MHD patients in China was 37.4%(95%CI=30.3%-44.5%).Age(OR=1.09,95%CI=1.06-1.13),age>60 years(OR=3.81,95%CI=2.31-6.30),female(OR=2.13,95%CI=1.47-3.08),living alone(OR=2.42,95%CI=1.22-4.80),sleep(OR=1.28,95%CI=1.08-1.50),depression(OR=1.97,95%CI=1.26-3.08),age on dialysis(OR=3.25,95%CI=1.82-5.79),social support(low level)(OR=1.99,95%CI=1.39-2.86),comorbidities(OR=1.79,95%CI=1.40-2.30),malnutrition(OR=1.17,95%CI=1.07-1.28),Charlson Comorbidity Index(CCI)(OR=1.32,95%CI=1.01-1.71),C-reactive protein(CRP)(OR=1.15,95%CI=1.09-1.21),hemoglobin(Hb<110 g/L)(OR=2.70,95%CI=1.67-4.36),comorbid diabetes(OR=2.16,95%CI=1.48-3.16),comorbid cerebrovascular disease(OR=2.66,95%CI=1.85-3.82),comorbid coronary heart disease(OR=3.50,95%CI=2.15-5.70) were risk factors for frailty MHD(P<0.05);economic income(OR=0.02,95%CI=0.01-0.14),social support(high level)(OR=0.86,95%CI=0.76-0.97),well nutrition(OR=0.4

关 键 词：维持性血液透析 衰弱 影响因素 中国 META分析 

分 类 号：R459.5[医药卫生—治疗学] R364[医药卫生—临床医学]