不同瘙痒评估量表在维持性血液透析患者尿毒症瘙痒评估中的应用效果比较  

Comparison of application effects of different pruritus assessment scales in assessment of uremia pruritus of patients with maintenance hemodialysis

作　　者：张雨婷 谭思雨 熊周 王沂芹 李墨奇 ZHANG Yuting;TAN Siyu;XIONG Zhou;WANG Yiqin;LI Moqi(Department of Nephrology,Second Affiliated Hospital of Army Military Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院肾内科,重庆400037

出　　处：《重庆医学》2024年第18期2799-2803,共5页Chongqing Medical Journal

摘　　要：目的对5-D瘙痒评估量表与多维度尿毒症瘙痒评估量表在维持性血液透析患者中的应用效果进行评估比较。方法选取2023年2-6月该院血液透析患者中有瘙痒症状的154例作为研究对象,分别使用5-D瘙痒评估量表和多维度尿毒症瘙痒评估量表对患者瘙痒程度、持续时间、瘙痒部位等维度进行评估。针对两种量表评估结果进行标准化处理后,采用Bland-AItman法进行一致性比较。采用Spearman相关系数检验两种量表的相关性。结果5-D瘙痒评估量表的一致限(LoA)置信区间为-0.1578~0.1603,多维度尿毒症瘙痒评估量表为-0.1592~0.1592;Spearman相关性结果显示,两种量表呈正相关(r=0.472,P<0.001)。5-D瘙痒评估量表中,持续时间、程度、发展方向、失能、分布分维度诊断瘙痒程度的AUC分别为0.674(95%CI:0.557~0.790)、0.799(95%CI:0.700~0.899)、0.637(95%CI:0.528~0.747)、0.951(95%CI:0.905~0.997)、0.786(95%CI:0.701~0.872);多维度尿毒症瘙痒评估量表中,症状体征、心理社会、睡眠分维度瘙痒程度的AUC分别为:0.989(95%CI:0.978~1.000)、0.931(95%CI:0.878~0.985)、0.951(95%CI:0.909~0.994)。结论两种量表的一致性较好,均可用于尿毒症皮肤瘙痒的评估。多维度尿毒症瘙痒评估量表在睡眠维度评估更具针对性,更适合维持性血液透析患者。Objective To conduct the evaluation and comparison on the application effects of the 5-D Pruritus Assessment Scale and the Multidimensional Uremic Pruritus Assessment Scale in the patients with maintenance hemodialysis.Methods A total of 154 maintenance hemodialysis patients with pruritus symptom in this hospital from February to June 2023 were selected as the study subjects.The 5-D Pruritus Assessment Scale and the Multidimensional Uremic Itch Assessment Scale were used to evaluate the dimensions such as the pruritus degree,duration and itching location.After standardization treatment by aiming at the evaluation results of the two kinds of scales,the Bland-AItman method was adopted to conduct the consistency comparison.The Spearman correlation coefficient was adopted to test the correlation between the two kinds of scales.Results The consensus limit(LoA)confidence interval of the 5-D Pruritus Assessment Scale was-0.1578 to 0.1603,the Multidimensional Uremic Pruritus Assessment Scale was-0.1592 to 0.1592.The Spearman correlation results showed that the two scales had the positive correlation(r=0.472,P<0.001).In the 5-D Pruritus Assessment Scale,the area under the curve(AUC)of the fractal dimensions such as duration,degree,development direction,disability and distribution were 0.674(95%CI:0.557-0.790),0.799(95%CI:0.700-0.899),0.637(95%CI:0.528-0.747),0.951(95%CI:0.905-0.997)and 0.786(95%CI:0.701-0.872),respectively.In the Multidimensional Uremic Pruritus Assessment Scale,AUC of the fractal dimensions such as symptom and sign,psychological society and sleep were 0.989(95%CI:0.978-1.000),0.931(95%CI:0.878-0.985),and 0.951(95%CI:0.909-0.994),respe ctively.Conclusion The consistency of the two scales is good,and both scales can be used to evaluate uremia skin pruritus.The Multidimensional Uremic Pruritus Assessment Scale is more targeted in the assessment of sleep dimension,which is more suitable for the evaluation of maintenance hemodialysis patients.

关 键 词：尿毒症瘙痒 维持性血液透析 评估量表 维度 比较 

分 类 号：R69[医药卫生—泌尿科学]