血液透析及腹膜透析患者生活质量评价及相关因素分析

Assessment of Quality of Life in Dialysis Population Using the KDQOL-SFTM Questionnaire and Analysis of Correlated Factors

目的:评估血液透析及腹膜透析患者的生活质量及相关影响因素。方法:随机抽取腹膜透析患者28例及血液透析患者28例,采用肾脏疾病生存质量专用量表KDQOL-SFTM量表对透析患者进行生活质量评估。比较血液透析患者和腹膜透析患者健康相关生活质量(HRQOL)的差异,并采用多元回归分析法探索分析透析人群HRQOL的影响因素。结果:血液透析患者和腹膜透析患者在KDQOL-SFTM量表各维度得分上差异无统计学意义,除外社会功能(SF)。血液透析患者SF得分高于腹膜透析患者(63.94±25.08vs48.66±23.41,P<0.05)。影响血液透析患者生活质量的因素包括:性别、年龄、透析龄、文化程度、钙磷乘积、血红蛋白(Hb)、甲状旁腺激素(PTH)等。上述因素对血液透析患者的HRQOL影响占14.1%～55.6%。影响腹膜透析患者生活质量的因素包括:性别、年龄、透析龄、体重指数(BMI)、糖尿病(DM)、Hb、血白蛋白(Alb)、PTH、铁蛋白、腹透方式、每日交换液量等。上述因素对腹膜透析患者的HRQOL影响占14.7%～58.6%。结论:透析患者的骨矿物质代谢紊乱、贫血严重影响生活质量。除此之外,腹膜透析患者的生活质量还受BMI、DM、营养状态、腹透龄的影响。临床中应积极纠正上述影响因素以提高透析患者的生活质量。

Objective：To evaluate the quality of life in dialysis population and to explore the correlated factors.Methods：A cross-sectional analysis of our chronic dialysis population was made using the disease-specific questionnaire-KDQOL-SFTm questionnaire.The Health-related quality of life （HRQOL） of patients with hemodialysis was compared against that of patients with peritoneal dialysis.Demographic,clinical and dialysis-related factors were assessed by multiple linear regression analysis for their contribution to the HRQOL in this population.Results：Twenty-eight patients with hemodialysis and 28 patients with peritoneal dialysis completed the KDQOL-SFTm questionnaire.The hemodialysis （HD） and peritoneal dialysis （PD） patients were similar in most aspects of the KDQOL-SFTm questionnaire except for social function （SF）.The score of SF in hemodialysis patients was significantly （63.94±25.08 vs 48.66±23.41,P0.05） greater than that in the peritoneal dialysis.Multiple linear regression analysis demonstrated that 14.1%～55.6% of hemodialysis patients and 14.7%～58.6% of peritoneal dialysis patients of the variance in the KDQOL-SFTm questionnaire subscales could be explained,respectively.Conclusion：The HRQOL of dialysis population was affected by anemia and mineral bone disorder.Besides,the HRQOL of peritoneal dialysis patients was impacted by body mass index （BMI）,status of diabetes,nutritional status and the length of time on dialysis.It would promote the HRQOL of dialysis population by improving all factors above.