血液透析患者胃肠道症状发生情况及其相关因素分析

Gastrointestinal symptoms and related factors among hemodialysis patients

目的:探讨慢性肾衰竭血液透析患者胃肠道症状发生情况及其相关因素。方法:方便选取105例血液透析患者,用胃肠道症状分级评分量表(GSRS)对患者的胃肠道症状进行评估,用Zung氏抑郁自评量表对患者的抑郁情况进行评估。同时收集患者的一般资料及每天的服药情况等信息。结果:本组血液透析患者消化不良、反流、便秘、进食障碍、腹泻、腹痛的发生率分别为60.7%、47.7%、46.7%、37.4%、33.6%和32.7%。以GSRS总分及各维度得分为因变量,抑郁、有无糖尿病、服药的种类、透析过程中进食情况、透析龄等作为自变量进行多因素线性回归,其抑郁得分(β=0.411,P<0.001)和服药种类(β=0.244,P=0.006)进入GSRS总分的方程(R2=0.239);抑郁得分(β=0.243,P=0.006)和糖尿病(β=0.421,P<0.001)进入便秘的方程(R2=0.270);抑郁得分(β=0.303,P=0.001)、服药种类(β=0.193,P=0.035)和血液透析过程中进食情况(β=0.209,P=0.023)进入消化不良的方程(R2=0.181);抑郁得分(β=0.379,P<0.001)进入进食障碍的方程(R2=0.144);糖尿病(β=0.364,P<0.001)进入腹泻的方程(R2=0.133)。结论:胃肠道症状在血液透析患者中比较常见,其中抑郁情况、服药种类数、糖尿病和透析过程中进食情况可能会影响血液透析患者的胃肠道症状。

Objective： To explore gastrointestinal symptoms and related factors in chronic renal failure hemodialysis patients. Methods： One hundred and five hemodialysis patient were recruited and investigated by demographic questionnaire, gastrointestinal symptom rating scale （GSRS） and Zung Self-rating Depression Scale （SDS） . The basic information and daily dosage of medication were obtained by interviewing patients and/or reviewing the medical records. Results： The incidences of indigestion, reflux, constipation, eating disorder, diarrhea, and abdominal pain were 60.7%,47.7%,46.7%,37.4%,33.6%, and 32.7% respectively. We used liner regression analysis to analyze the related factors of GSRS and its subscale with significance level of 0.05. Depression （β=0.411, P〈0.001） and daily medicine types （β=0.244, P=0.006） entered the equation of general GSRS （R2=0.239）. Depression （β=0.243, P=0.006） and diabete （β=0.421, P〈0.001） entered the constipation equation （R2=0.270）. Depression （β=0.303, P=0.001）,daily medication types （β=0.193, P=0.035）and food intake condition in dialysis session （β=0.209, P=0.023） entered the indigestion equation （R2=0.181）. Only depression （β=0.379, P〈0.001） entered the eating disorder equation （R2=0.144） and diabete （β=0.364, P〈0.001） entered diarrhea equation （R2=0.133）. Conclusion： Gastrointestinal symptoms were common in hemodialysis patients. Depression, daily medicine types, diebete, and food intake condition in dialysis session may predict gestrointestinal symptoms.