摘要
目的了解65岁以上慢性肾脏病(chronic kidney disease,CKD)患者的老年综合评估评分情况,并分析患者生活质量的相关影响因素。方法本研究为回顾性队列研究,入选2016年10月至2019年10月在山西省人民医院肾内科诊断为CKD且65岁以上的189例患者,依据患者是否透析分为透析组(n=90例)和非透析组(n=99例)。简明老年综合评估评分包括年龄、基本日常生活活动(basic activities of daily living,BADL)能力评估、工具性日常生活活动(instrumental activities of daily living,IADL)能力评估以及改良老年疾病累计评分表(modified cumulative illness rating score for geriatrics,MCIRS-G),收集患者的临床资料。采用Pearson相关分析分析不同量表评分与各个临床指标之间的相关关系,进一步使用多元线性回归分析老年CKD患者生活质量的相关影响因素。结果与非透析组相比,透析组患者的BADL评分及IADL评分均显著降低[(70.00±33.28)分比(93.38±14.32)分,t=6.166,P<0.001;(9.78±7.12)分比(15.95±5.74)分,t=6.520,P<0.001],而MCIRS-G评分显著升高[(31.13±4.00)分比(27.29±5.17)分,t=-5.741,P<0.001]。对非透析组患者数据行线性回归分析,结果显示,与BADL评分呈正相关的因素为估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、血尿酸、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、血钾和血氯(均P<0.05),呈负相关的因素为B型钠尿肽(P<0.01);与IADL评分呈正相关的因素为eGFR、血尿酸、HDL-C、LDL-C、血钾和血氯(均P<0.05),呈负相关的因素为年龄和B型钠尿肽(均P<0.05)。无论是否包含肾脏评分,空腹血糖均与MCIRS-G评分呈正相关,eGFR、血尿酸、总胆固醇和HDL-C与MCIRS-G评分呈负相关(均P<0.05)。多元线性回归结果显示,BADL的独立影响因素为eGFR(P<0.01),IADL评分的独立影响因素为年龄和eGFR(均P<0.05)。结论老年CKD患
Objective To understand the comprehensive geriatric assessment(CGA)scores in chronic kidney disease(CKD)patients aged 65 years and older,and analyze the related influencing factors of quality of life.Methods A total of 189 patients who were over 65 years old and diagnosed with CKD in the Department of Nephrology of Shanxi Provincial People's Hospital from October 2016 to October 2019 were included retrospectively.The patients were divided into dialysis group(n=90 cases)and non-dialysis group(n=99 cases)according to whether dialysis or not.The concise CGA scores included age,basic activities of daily living(BADL),instrumental activities of daily living(IADL),and modified cumulative illness rating score for geriatrics(MCIRS-G).Pearson correlation analysis was used to analyze the relationship between different scale scores and clinical indexes.Multiple linear regression analysis was used to further analyze independent related factors of the quality of life in elderly CKD patients.Results Compared with the non-dialysis group,the BADL score and IADL score in the dialysis group were significantly reduced[(70.00±33.28)vs(93.38±14.32),t=6.166,P<0.001;(9.78±7.12)vs(15.95±5.74),t=6.520,P<0.001],while the MCIRS-G score was significantly increased[(31.13±4.00)vs(27.29±5.17),t=-5.741,P<0.001].Linear regression analysis performed on the data of non-dialysis group patients showed that estimated glomerular filtration rate(eGFR),serum uric acid(SUA),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),blood potassium and chlorine were positively correlated with BADL and IADL scores(all P<0.05).B-type natriuretic peptide(BNP)was negatively correlated with BADL score(P<0.01).BNP and age were negatively correlated with IADL score(both P<0.05).Fasting blood glucose(FBG)was positively correlated with MCIRS-G or MCIRS-G other than kidney(both P<0.05),and eGFR,SUA,total cholesterol,and HDL-C were negatively correlated with MCIRS-G or MCIRS-G other than kidney(all P<0.05).Multiple linear regression
作者
黄颖
董丽娜
李荣山
薛临萍
Huang Ying;Dong Lina;Li Rongshan;Xue Linping(Department of Geriatrics,Shanxi Provincial People's Hospital,Taiyuan 030012,China;Department of Central Laboratory,Shanxi Provincial People's Hospital,Taiyuan 030012,China;Department of Renal Medicine,Shanxi Provincial People's Hospital,Taiyuan 030012,China)
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2021年第1期16-22,共7页
Chinese Journal of Nephrology
基金
2018年科技部“主动健康和老龄化科技应对”专项项目(2018YFC2002004)。
关键词
肾功能不全
慢性
生活质量
危险因素
Renal insufficiency,chronic
Quality of life
Risk factors
