蛋白质能量消耗对终末期肾病维持性血液透析病人生活质量的影响

    Effect of protein-energy wasting on quality of life in maintenance hemodialysis patients with end-stage renal disease

    • 摘要:
      目的研究维持性血液透析(MHD)病人的蛋白质能量消耗(PEW)情况对于病人生活质量的影响。
      方法抽取符合纳入标准的行MHD治疗的终末期肾病(ESRD)病人150例,根据PEW情况分为PEW组(n=33)和非PEW组(n=117)。采用KDQOLTM-36量表对比分析2组病人的生活质量评分。
      结果满足至少3个PEW诊断指标的有33例,患病率为22.0%;PEW组病人的透析前收缩压、舒张压、心率,以及上臂围、肱三头肌皮褶厚度、臀围、握力、白蛋白、肌酐值均低于非PEW组(P < 0.05);PEW组透析时间长于非PEW组,体质量指数低于非PEW组(P < 0.05);生活质量评分中,PEW组活力、社会功能、社会情感、症状影响、肾病影响、总分值方面均低于非PEW组,差异均有统计学意义(P < 0.05~P < 0.01)。
      结论PEW是接受MHD的终末期肾病病人的常见并发症,对病人生活质量的影响应得到更多关注。

       

      Abstract:
      ObjectiveTo study the effect of protein-energy wasting(PEW) on the prognosis of maintenance hemodialysis(MHD) patients.
      MethodsA total of 150 patients with end-stage renal disease who were subject to MHD, were enrolled in the invstigation and divided into PEW group(n=33) and non-PEW group(n=117) according to the diagnosis critiria of PEW syndorome. The quality of life scores by KDQOLTM-36 scale in the two groups were compared and analyzed.
      ResultsThirty-three cases met at least three diagnostic indexes of PEW with a percentage of 22.0%. The values of systolic blood pressure, diastolic blood pressure, heart rate, upper arm circumference, triceps skinfold thickness, hip circumference, grip strength, albumin and creatinine in PEW group were significantly lower than those in non-PEW group(P < 0.05);the time of dialysis in the PEW group was longer than that in the non-PEW group, and body mass index was lower than that in the non-PEW group(P < 0.05). There were significant differences in vitality, social function, social emotion, symptom influence, nephropathy influence and total score between PEW group and non PEW group(P < 0.05 to P < 0.01).
      ConclusionsPEW is a common complication in end-stage renal disease patients receiving MHD and its impact on patients' quality of life should be given more attention.

       

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