安徽省血液透析患者尿毒症瘙痒患病率调查及影响因素分析  

Prevalence rate and influencing factors of uremic pruritus in hemodialysis patients in Anhui province

作　　者：王菊[1] 王心亮 萧健萍 王瑞峰[1] 王德光[1] Wang Ju;Wang Xinliang;Xiao Jianping;Wang Ruifeng;Wang Deguang(Dept of Nephrology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601;Blood Purification Center,The Second People′s Hospital of Fuyang,Fuyang 236000)

机构地区：[1]安徽医科大学第二附属医院肾脏内科,合肥230601 [2]阜阳市第二人民医院血液净化中心,阜阳236000

出　　处：《安徽医科大学学报》2024年第3期527-532,共6页Acta Universitatis Medicinalis Anhui

基　　金：安徽省教育厅高校科学研究重点项目(编号:KJ2020A0179);安徽医科大学第二附属医院临床研究培育计划一般项目(编号:2021LCYB20)。

摘　　要：目的探究安徽省维持性血液透析(MHD)患者尿毒症瘙痒(UP)患病率及其影响因素。方法收集在安徽省27家血透中心进行MHD的患者,并对其临床资料进行比较。结果共3025例MHD患者,UP患病率为63.3%,其中轻度UP 55.9%,中重度UP 7.4%。皖南、皖中以及皖北总UP患病率分别为75.4%、63.6%以及57.9%。年龄段在≤30岁、31~50岁、51~70岁以及≥71岁对应总UP患病率分别为53.5%、59.8%、65.4%以及65.9%。总UP和中重度UP患病率随着年龄的增加而增加(P<0.01)。UP组患者年龄、透析龄、高血压比例、25-α羟维生素D_(3)[25(OH)D_(3)]水平、使用低通量透析器比例以及使用含钙磷结合剂患者的比例高于无UP组,而UP组透析后舒张压、血红蛋白水平、血液透析滤过(>2周/次)比例低于无UP组(P<0.05)。中重度UP组患者年龄、高血压比例、糖尿病比例均高于轻度UP组,而非含钙磷结合剂使用比例低于轻度UP组(P<0.05)。二分类Logistic回归分析表明高25(OH)D_(3)水平与MHD患者UP的高风险相关(P<0.05),高通量透析器的使用与MHD患者UP的低风险相关(P<0.05)。结论安徽省维持性血液透析患者UP患病率为63.3%。皖南地区的UP患病率最高,总UP和中重度UP患病率随着年龄的增加而增加。高25(OH)D_(3)水平是MHD患者UP发生的危险因素,而高通量透析器的使用能够降低MHD患者UP风险。Objective To explore the prevalence of uremic pruritus(UP)in patients with maintenance hemodialysis(MHD)in Anhui Province and its influential factors.Methods Patients with MHD were enrolled in 27 hemodialysis centers in Anhui Province.Clinical data were compared.Results A total of 3025 patients with MHD were included.The prevalence of UP was 63.3%,among them,mild UP 55.9% and moderate to severe UP 7.4%.The prevalence rates of UP in southern Anhui,central Anhui and northern Anhui were 75.4%,63.6% and 57.9%.The prevalence of total UP in≤30 years,31-50 years,51-70 years and≥71 years was 53.5%,59.8%,65.4% and 65.9%.The prevalence of total UP and moderate to severe UP increased with age(P<0.01).Age,age of dialysis,proportion of hypertension,25(hydroxy)vitamin D_(3)[25(OH)D_(3)],proportion of low flux dialyzer usage and proportion of calcium-phosphorus binder usage in UP group were higher than those in the group without UP.However,the levels of diastolic blood pressure,hemoglobin(Hb)and hemodialysis filtration ratio in the UP group were lower than those in the non-UP group(P<0.05).By comparison,the age,hypertension and diabetes of patients in moderate and severe UP group were higher than those in mild UP group,while the proportion of non-calcium-phosphorus binding was lower than that in mild UP group(P<0.05).Binary Logistic regression analysis showed that high 25(OH)D_(3) was associated with a higher risk of UP in MHD patients,and high throughput dialyzer use was associated with a lower risk of UP in MHD patients(P<0.05).Conclusion The prevalence rate of UP in maintenance hemodialysis patients in Anhui province is 63.3%.The prevalence of UP is the highest in southern Anhui,and the prevalence of total UP and moderate to severe UP increases with age.High 25(OH)D_(3) levels are a risk factor for UP in MHD patients,and the use of high-throughput dialyzers can reduce the risk of UP in MHD patients.

关 键 词：肾功能衰竭 血液透析 尿毒症瘙痒 25-羟维生素D_(3) 高通量透析器 流行病学研究 

分 类 号：R459.5[医药卫生—治疗学]