摘要
目的:了解维持性血液透析(MHD)患者瘙痒症的患病情况及相关因素。方法:于2018年10月至2019年10月采用分层抽样的方法,在江苏省抽取24个血液净化中心,调查其所有MHD患者的皮肤瘙痒情况及临床资料,分析瘙痒相关因素。结果:纳入MHD患者3819例,瘙痒症患病率为27.55%,中度至极重度瘙痒的患病率为18.02%,瘙痒症中位病程为12.00月。在瘙痒症患者中,偶尔、轻微搔抓者比例最高,超过一半的患者存在抓痕,常规药物治疗有效率为42.21%。年龄≥45岁、体表面积增加、舒张压降低、吸烟、饮酒、继发性甲状旁腺功能亢进病史、使用华法林、存在肌无力、骨痛、转移性钙化和骨质疏松的症状、血清钙和血清磷水平升高可增加MHD患者瘙痒症的患病风险。结论:MHD患者皮肤瘙痒程度较轻,但治疗有效率低。肾科医生应重视透析患者的瘙痒症,对患者的生活习惯、合并症、慢性肾脏病矿物质与骨异常相关情况及时干预,以缓解瘙痒症状、改善患者生存质量。
Objective:To investigate the prevalence and risk factors of pruritus in maintenance hemodialysis(MHD)patients,and to explore risk factors of pruritus.Methodology:A questionnaire survey involving skin pruritus and clinical data was conducted among MHD patients from 24 hemodialysis centers which were selected by stratified sampling in Jiangsu Province from October 2018 to October 2019.The relevant factors of pruritus were analyzed.Results:A total of 3819 MHD patients were included.The prevalence of pruritus and moderate-to-extreme pruritus was 2755%and 18.02%,respectively.The median duration of pruritus was 12.00 months.Among patients with pruritus,the proportion of occasional and slight scratching was the highest,and more than half of the patients had scratches.The effective rate of conventional drug treatment was 42.21%.Multivariate regression analysis showed that age≥45 years,increased body surface area,low diastolic blood pressure,smoking,drinking,history of secondary hyperparathyroidism,warfarin,muscle weakness,bone pain,metastatic calcification,osteoporosis,serum calcium and serum phosphorus levels are risk factors for pruritus in MHD patients.Conclusion:The degree of pruritus in MHD patients is mild while the effective rate of treatment is 42.21%.Nephrologists should pay attention to pruritus in dialysis patients,and timely intervention should be given to patients'living habits,comorbidities,chronic kidney diseasemineral and bone disorders,so as to relieve pruritus and improve their quality of life.
作者
施雯
刘玉秋
张留平
王小兵
孙伟
张以来
司佶宜
徐甜
谢筱彤
刘宏
张晓良
SHI Wen;LIU Yuqiu;ZHANG Liuping;WANG Xiaobing;SUN Wei;ZHANG Yilai;SI Jiyi;XU Tian;XIE Xiaotong;LIU Hong;ZHANG Xiaoliang(Department of Nephrology,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Nephrology,Wuxi No.5 People’s Hospital,Wuxi 214007,China;Department of Nephrology,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Department of Nephrology,Shuyang County Hospital of Traditional Chinese Medicine,Suqian 223600,China)
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2023年第3期220-225,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
基金
江苏省重点研发计划-社会发展(BE2021737)
南京市卫生科技发展专项(YKK20237,YKK21268)。
关键词
瘙痒
血液透析
流行病学调查
患病率
危险因素
pruritus
hemodialysis
epidemiological investigation
prevalence
risk factors
