| 曹世琦,许贤荣,冯 进,朱亚梅,杨家慧,马 逊,马 晴.基于Logistic回归模型分析维持性血液透析患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响[J].,2022,(21):4180-4184 |
| 基于Logistic回归模型分析维持性血液透析患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响 |
| Based on Logistic Regression Model to Analyze the Risk Factors of Sarcopenia in Maintenance Hemodialysis Patients and Their Effects on the Quality of Life, Negative Emotion and Survival Status of Patients |
| 投稿时间：2022-04-13 修订日期：2022-05-10 |
| DOI：10.13241/j.cnki.pmb.2022.21.033 |
| 中文关键词: 维持性血液透析 肌少症 危险因素 生活质量 负性情绪 生存状况 |
| 英文关键词: Maintenance hemodialysis Sarcopenia Risk factors Quality of life Negative emotion Survival status |
| 基金项目:江苏省临床医学科技专项基金项目（BL20170681） |
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| 中文摘要: |
| 摘要 目的：基于Logistic回归模型分析维持性血液透析（MHD）患者肌少症的危险因素及其对患者生活质量、负性情绪及生存状况的影响。方法：选取江苏省人民医院肾内科肾脏病重症病房于2019年2月-2021年2月期间收治的MHD患者289例，收集所有患者的一般资料，根据是否患有肌少症将患者分为肌少症组（n=71）及非肌少症组（n=218）。采用单因素和多因素Logistic回归模型分析MHD患者肌少症的危险因素，并观察两组生活质量、负性情绪及生存状况。结果：肌少症组、非肌少症组在年龄、透析时间、规律运动、体质量指数（BMI）、人体蛋白质含量（PM）、去脂体质量（FFM）、改良定量主观评估表（MQSGA）评分、血磷、超敏C反应蛋白（hs-CRP）、血肌酐、前白蛋白、白蛋白组间对比差异有统计学意义（P<0.05）。多因素Logistic回归分析，结果显示年龄偏大、透析时间偏长、BMI下降、MQSGA评分偏高、hs-CRP偏高、血肌酐偏高是MHD患者发生肌少症的危险因素，高血磷、规律运动则是其保护因素（P<0.05）。肌少症组患者的精神健康、生理职能、总体健康、生理功能、社会功能、活力、躯体疼痛、情感职能评分均低于非肌少症组（P<0.05）。肌少症组患者的抑郁自评量表（SDS）、焦虑自评量表（SAS）评分高于非肌少症组（P<0.05）。随访1年后，肌少症组的死亡率明显高于非肌少症组（P<0.05）。结论：MHD患者并发肌少症受到年龄、透析时间、BMI、MQSGA评分、hs-CRP、血肌酐、血磷、规律运动等因素的影响，且并发肌少症的患者其抑郁焦虑程度更重，生活质量更差，生存期缩短。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors of sarcopenia in maintenance hemodialysis (MHD) patients based on Logistic regression model and their effects on the quality of life, negative emotion and survival status of patients. Methods: 289 MHD patients who were admitted to the Renal Disease Intensive Care Unit of Nephrology Department of Jiangsu Province Hospital from February 2019 to February 2021 were selected. The general data of all patients were collected. According to whether they had sarcopenia, the patients were divided into sarcopenia group (n=71) and non-sarcopenia group (n=218). Univariate and multivariate Logistic regression models were used to analyze the risk factors of sarcopenia in MHD patients, and the quality of life, negative emotions and survival status of the two groups were observed. Results: There were significant differences in age, dialysis time, regular exercise, body mass index (BMI), human protein content (PM), fat free mass (FFM), Modified Quantitative Subjective Global Assessment (MQSGA) score, blood phosphorus, hypersensitive C-reactive protein (hs-CRP), blood creatinine, prealbumin and albumin between the sarcopenia group and the non-sarcopenia group (P<0.05). Multivariate Logistic regression analysis showed that older age, longer dialysis time, lower BMI, higher MQSGA score, higher hs-CRP and higher blood creatinine were the risk factors for sarcopenia in MHD patients, while high blood phosphorus and regular exercise were the protective factors (P<0.05). The scores of mental health, physiological function, overall health, physiological function, social function, vitality, physical pain and emotional function of sarcopenia patients were lower than those of non-sarcopenia group (P<0.05). The scores of self rating Depression Scale (SDS) and self rating Anxiety Scale (SAS) in sarcopenia group were higher than those in non-sarcopenia group(P<0.05). 1 year after follow-up, the mortality of sarcopenia group was significantly higher than that of non-sarcopenia group (P<0.05). Conclusion: MHD patients complicated with sarcopenia are affected by age, dialysis time, BMI, MQSGA score, hs-CRP, blood creatinine, blood phosphorus, regular exercise and other factors. Moreover, patients complicated with sarcopenia have more depression and anxiety, worse quality of life and shorter survival. |
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