摘要
目的了解维持性血液透析(maintenance hemodialysis,MHD)患者慢性便秘的患病率,分析慢性便秘的危险因素。方法采用横断面调查研究方法,入选2021年9月1日至2021年9月30日在广州市花都区人民医院接受MHD治疗的患者为研究对象,收集患者人口学、一般资料和实验室检查资料。通过发放调查问卷的方法评估患者焦虑程度和生活质量。采用罗马Ⅳ标准诊断慢性便秘,根据患者是否合并慢性便秘分为便秘组和非便秘组,比较两组患者临床资料的差异。采用Logistic回归模型法分析MHD患者慢性便秘的危险因素。结果321例MHD患者入选本研究,男168例,女153例,年龄(59.5±13.4)岁(范围29~87岁),慢性便秘160例(49.8%)。便秘组男性、长透析龄、服用司维拉姆和碳酸镧、糖尿病肾病及合并糖尿病占比高于非便秘组,两组间比较差异均有统计学意义(均P<0.05)。便秘组患者血钙、血磷、钙磷乘积、焦虑程度评分、周平均超滤量/干体重等显著高于非便秘组,血白蛋白、血镁、尿素清除指数和老年营养风险指数评分(GNRI)显著低于非便秘组,两组间比较差异均具有统计学意义(均P<0.05)。Logistic回归分析结果显示,中重度焦虑(中度,OR=3.233,95%CI 1.339~7.805,P=0.009;重度,OR=5.103,95%CI 1.906~13.663,P=0.001)、存在营养风险(低风险,OR=3.705,95%CI 1.440~9.533,P=0.007;中度风险,OR=5.638,95%CI 2.557~12.430,P<0.001;严重风险,OR=15.097,95%CI 4.112~55.436,P<0.001)、年龄>60岁(以年龄≤40岁为参照,OR=4.050,95%CI 1.366~12.006,P=0.012)、有糖尿病病史(OR=2.224,95%CI 1.253~3.946,P=0.006)、服用司维拉姆(OR=2.290,95%CI 1.207~4.346,P=0.011)及钙磷乘积(OR=1.704,95%CI 1.329~2.186,P<0.001)、全段甲状旁腺素(OR=1.013,95%CI 1.003~1.022,P=0.007)、血尿素氮(OR=1.092,95%CI 1.002~1.189,P=0.045)、血镁(OR=0.042,95%CI 0.006~0.294,P=0.001)水平是MHD患者发生慢性便秘的独立影响因素。结论MHD患者慢性便秘患病率为49.8%。充�
Objective To investigate the prevalence of chronic constipation in maintenance hemodialysis(MHD)patients and analyze the risk factors of chronic constipation.Methods Using the cross-sectional survey method,patients who received MHD in Huadu District People′s Hospital of Guangzhou from September 1,2021 to September 30,2021 were enrolled as the research objects.The patient′s demographic,general data and laboratory results were collected.The anxiety level and quality of life were assessed by questionnaires.The patients were divided into constipation group and non-constipation group according to whether they had chronic constipation.The RomeⅣcriteria was used to diagnose chronic constipation,and the differences of clinical data between the constipation group and the non-constipation group were compared.The risk factors of chronic constipation in MHD patients were analyzed by logistic regression analysis method.Results A total of 321 MHD patients were enrolled in this study,with 168 males,153 females and age of(59.5±13.4)years old(ranged from 29 to 87 years old).There were 160 patients(49.8%)with chronic constipation.The proportions of males,long dialysis age,taking sevelamer and lanthanum carbonate,diabetic nephropathy,and diabetes in the constipation group were higher than those in the non-constipation group,and the differences between the two groups were statistically significant(all P<0.05).The serum calcium,serum phosphorus,calcium-phosphorus product,anxiety scores,average weekly ultrafiltration volume/dry weight in the constipation group were significantly higher than those in the non-constipation group(all P<0.05),and the serum albumin,serum magnesium,urea clearance index(Kt/V)and geriatric nutritional risk index were significantly lower than those in the non-constipation group(all P<0.05).The results of logistic regression analysis showed that moderate to severe anxiety(moderate,OR=3.233,95%CI 1.339-7.805,P=0.009;severe,OR=5.103,95%CI 1.906-13.663,P=0.001),existed risk of nutrition(low risk,OR=3.705,95%
作者
陈家臣
雷子涵
李文豪
苏妍妍
张云芳
Chen Jiachen;Lei Zihan;Li Wenhao;Su Yanyan;Zhang Yunfang(The Third School of Clinical Medicine,Southern Medical University,Guangzhou 510600,China;Department of Nephrology,Affiliated Huadu Hospital,Southern Medical University(Huadu District People′s Hospital of Guangzhou),Guangzhou 510800,China)
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2022年第10期889-898,共10页
Chinese Journal of Nephrology
基金
广州市医学重点学科建设项目(2021-2023)
广州市花都区医疗卫生一般科研专项(20-HDWS-025、20-HDWS-033、22-HDWS-041)。
关键词
肾透析
便秘
危险因素
Renal dialysis
Constipation
Risk factors
