摘要
目的 探讨老年维持性血液透析(MHD)患者症状潜在类别随时间变化的模式。方法 2021年6月—2022年6月,选取122例于复旦大学附属华山医院行MHD治疗的老年患者。2021年6月(T1)进行基线调查,2021年12月(T2)及2022年6月(T3)进行随访。收集受试者的人口学资料及临床资料,评估患者的透析症状指数(DSI)。对发生率≥20%的症状建立潜类别模型,通过潜类别分析,对T1~T3的症状测量条目进行潜在转换分析,以logistic回归分析潜在类别转换的影响因素。结果 122例老年MHD患者年龄60~93岁,平均(68.6±8.1)岁,其中男性65例、女性57例。T1、 T2及T3时所有患者DSI得分为13.00(6.00, 24.00)分、16.00(8.00, 28.00)分、18.00(11.00, 32.00)分。21个症状发生率≥20%,分别为便秘、食欲减退、肌肉痉挛、呼吸短促、头晕、足麻或刺痛、疲乏、咳嗽、口干、骨或关节痛、头痛、肌肉痛、注意力难以集中、皮肤干燥、瘙痒、忧虑、入睡困难、难以熟睡、易怒、性欲减退以及性冲动困难。T1~T3时入睡困难为中度困扰2.00(0.00, 4.00)分,其余症状在不同时间点的困扰程度均较低。老年MHD患者可分为症状低发(C1组,n=95)与症状高发(C2组,n=27)2个潜在类别。T1、 T2及T3时,2组MHD患者数差异均有统计学意义(P<0.001)。T1、 T2及T3时,2组食欲减退及骨或关节痛构成比差异有统计学意义(P<0.05)。多因素logistic回归分析显示,T1~T3时食欲减退和骨或关节痛为老年MHD患者症状高发的危险因素。结论 老年MHD患者可分为症状高发与症状低发2个潜在类别,食欲减退与骨或关节痛可能是其症状高发的促进因素。
Objective To explore the potential categories of symptoms in elderly maintenance hemodialysis(MHD)patients and their change pattern over time.Methods From June 2021 to June 2022,122 elderly patients receiving MHD treat⁃ment in Huashan Hospital Affiliated to Fudan University were selected.A baseline survey was conducted in June 2021(T1),and follow⁃up visits were conducted in December 2021(T2)and June 2022(T3),respectively.The demographic and clinical data of the subjects were collected,their dialysis symptom index(DSI)was evaluated.A potential category model was estab⁃lished for symptoms with an incidence of≥20%.Through potential category analysis,the potential conversion analysis was performed on the symptom measurement items from T1 to T3,and the influencing factors of potential category conversion were analyzed by logistic regression.Results The average age of 122 elderly MHD patients was(68.6±8.1)years old,ranging from 60 to 93 years old,including 65 males and 57 females.Their total score of DSI in T1,T2 and T3 were 13.00(6.00,24.00),16.00(8.00,28.00),18.00(11.00,32.00),respectively.The incidence of 21 symptoms was≥20%,including constipation,loss of appetite,muscle cramps,shortness of breath,dizziness,numbness or tingling in the feet,fatigue,cough,dry mouth,bone or joint pain,headache,muscle pain,difficulty concentrating,dry skin,itching,anxiety,difficulty falling asleep,difficulty falling asleep,irritability,decreased libido,and difficulty in sexual impulse.From T1 to T3,the distress of dif⁃ficulty falling asleep was moderate distress[2.00(0.00,4.00)points],and the distress degree of other symptoms was low at different time points.The elderly MHD patients could be divided into two potential categories:low incidence of symptom(C1 group,n=95)and high incidence of symptom(C2 group,n=27).At T1,T2 and T3,there were significant differences in the number of MHD patients and the constituent ratio of anorexia and bone/joint pain between the two groups(P<0.05).Multivari⁃ate logistic regression analysis s
作者
翁佳敏
王梦婧
黄碧红
陆楚涵
陈靖
杨晓莉
Weng Jiamin;Wang Mengjing;Huang Bihong;Lu Chuhan;Chen Jing;Yang Xiaoli(Department of Nephrology,Huashan Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China;Department of Nursing,Huashan Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2023年第2期294-298,308,共6页
Geriatrics & Health Care
基金
上海市卫生和计划生育委员会科研课题资助项目(201640126)
促进市级医院临床技能与临床创新能力三年行动计划项目(SHDC2020CR4014)。
关键词
老年
维持性血液透析
潜类别分析
潜在转换分析
elderly
maintenance hemodialysis
potential category analysis
potential conversion analysis
