文章摘要
谢敏妍 刘海俊 陈锦华 梁智敏 张东升 雷萍.透析充分性、微炎症、营养状态对血液透析患者生存质量及长期生存率的影响[J].,2014,14(23):4532-4536
透析充分性、微炎症、营养状态对血液透析患者生存质量及长期生存率的影响
The Effect of Dialysis Adequacy, Microinflammation and Nutritional Statuson the Quality of Life and Survival Rate in Maintenance Hemodialysis Patients
  
DOI:
中文关键词: 肾透析  透析充分性  微炎症  营养状况  生存质量  生存率
英文关键词: Renal dialysis  Dialysis adequacy  Microinflammation  Nutritional status  Quality of life  Survival rate
基金项目:广东省科技计划项目基金项目(00693731120201014)
作者单位
谢敏妍 刘海俊 陈锦华 梁智敏 张东升 雷萍 广东番禺区中心医院肾病风湿科 
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中文摘要:
      目的:探讨透析充分性、微炎症、营养状态对血液透析患者生存质量及长期生存率的影响。方法:随机选择我院血液透析中 心维持透析每周3 次,治疗6 月以上的患者89 例,观察并评估其入组时、入组后第3、6、12、18、24 月的生存质量(KDTA、SF-36)、 营养状况(MQSGA、MAMC)、微炎症(hCRP、IL-6)及透析充分性(iPTH、Kt/V、beta2-MG),并分析透析充分性、营养状况、微炎症与生 存质量、生存率的相关性。结果:89 例患者有9 例死亡,死亡率为10.1 %;iPHT、MQSGA与KDTA、SF-36 呈负相关(P<0.05),Kt/V 与KDTA、SF-36 呈正相关(P<0.05),beta2-MG、胆固醇与KDTA、SF-36 无明显相关(P>0.05);hCRP、IL-6 分别与KDTA、SF-36 呈负相 关(P<0.05);HGS 与KDTA 呈正相关(P<0.05),与SF-36 无明显相关(P>0.05),ALB、MAMC 与KDTA、SF-36 呈正相关(P<0.05); Kt/V、MQSGA、IL-6、iPTH 均与KDAT 及SF-36 存回归关系(P<0.05);Cox 回归模型发现Kt/V、ALB 及开始透析年龄是导致血透 患者死亡的危险因素(P<0.05)。结论:透析充分性、微炎症及营养状况均影响透析患者的生存质量及长期生存率;iPTH 、Kt/V、 MQSGA、IL-6 是其生存质量的独立影响因素,Kt/V、ALB 及开始透析年龄是血透患者的死亡独立危险因素。
英文摘要:
      Objective:To study the effect of dialysis adequacy, microinflammation and nutritional status on the quality of life (Qol) and survival rate in maintenance hemodialysis patients.Methods:This was a prospective study on 89 cases of long-term hemodialysis patients. The Qol(KDTA, SF-36), survival rate, nutritional status(MQSGA, MAMC), microinflammation (hCRP, IL-6) and dialysis adequacy (iPTH, Kt/V,beta2-MG) were evaluated at beginning, the 3th, 6th , 12th, 18th and 24th month, and then calculated the means and analyzed the correlation of dialysis adequacy, microinflammation and nutritional status with Qol and survival rate.Results:9 cases out of 89 died, mortality was 10.1 %; There was negative correlation between iPTH and KDTA, SF-36, while the correlation of Kt/V with KDTA and SF-36 was positive; There was no correlation of beta2-MG with KDTA and SF-36; there were negative correlation of hCRP and IL-6 with KDTA and SF-36; There were negative correlation of MQSGA with KDTA and SF-36, and HGS had positive correlation with KDTA respectively, while no correltion with SF-36; ALB and MAMC had positive correlation with KDTA and SF-36, while there was no correlation of cholesterol with KDTA and SF-36; Kt/V, MQSGA, IL-6, iPTH had regressive association to KDTA and SF-36; The Cox regression analysis revealed that Kt/V, ALB and beginning dialysis age were significant determinants of mortality in long-term hemodialysis patients.Conclusion:The dialysis adequacy, microinflammation and nutritional status had effect on KDTA and SF-36; Kt/V, MQSGA, IL-6, iPTH were the independent factors of KDTA and SF-36; Kt/V, ALB and beginning dialysis age were the death risk factors of hemodialysis patients.
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