维持性血液透析患者不安腿综合征危险因素分析

Risk factors for restless legs syndrome in patients with maintenance hemodialysis

目的 探索维持性血液透析患者不安腿综合征发生的影响因素.方法 采用流行病学调查,获得病例信息和临床检测结果,分析不安腿综合征的发生及其可能危险因素.数据比较成组t或t＆#39;或卡方检验完成.回归采用Logistic分析探索危险因素.结果 本次调查结果显示维持性血液透析患者不安腿综合征发生率为21.5％（95％ CI 15.60％～27.41％）.单因素分析时,未见个人基本情况（年龄、性别、体质量指数、透析时间）、个人生活习惯（吸烟、饮酒）、机体营养状况（血清总蛋白）、肝脏损伤程度（谷丙转氨酶、谷草转氨酶、谷氨酰转移酶、碱磷酶）、透析有效性状况（血清肌酐、血清尿素氮、尿酸）、血气状况（二氧化碳结合力）、血清离子状况（阴离子间隙、K、Ca、P、Fe）、代谢状况（三酰甘油、胆固醇）及激素（甲状旁腺素、促红细胞生成素）等与不安腿的发生有关.多因素Logistic回归分析结果显示体质量指数高（OR=0.68,95％ CI 0.49～0.94,P=0.02）和阴离子间隙高（0R=0.48,95％ CI 0.28～0.83,P=0.01）等因素是保护因素.吸烟（0R=4031.32,95％ CI 25.99～625413.34,P=0.00）、血清总蛋白高（OR=1.40,95％ CI 1.02～1.92,P=0.04）、血清尿素氮水平高（OR=1.59,95％ CI 1.19～2.52,P=0.00）、血清钾浓度高（OR=8.86,95％ CI 1.39～56.38,P=0.02）是不安腿综合征的危险因素.结论 不安腿综合征的发生可能是个人因素、个人生活习惯、机体营养状况、透析有效性状况以及血清离子状况等因素联合发生作用所致.

Objectives To explore the risk factors for restless legs syndrome （RLS） in patients with maintenance hemodialysis （MHD）. Methods An epidemiological investigation was carried out on MHD patients. Basic information and clinical laboratory examinations were collected and the associations with Ri S was explored. Grouped data were compared using Student＇ s t or t＇ test or chi square test for univariate analyses. Binary logistic analysis was used for exploring multivariate factors. Results The prevalence rate of RLS was 21.5% （95% CI 15.60～27.41%）. No differences existed between RLS group and none-RLS group in personal factors （age, gender, BMI and MHD duration）, personal habits （smoking and drinking）, nutrition condition （serum total protein）, liver injury （GOT, GPT, GGT and ALP）, MHD effectiveness （SCr, BUN and UA）, blood gas （CO2CP）, serum electrolytes （anion gap, K, Ca, P and Fe）, metabolism conditions （triglyceride and cholesterol）, and endocrinal levels （PTH and EPO）. However, binary logistic analysis showed that BMI （OR=0.68, 95% CI0.49～0.94） and anion gap （OR=0.48, 95% CI0.28～0.83） were the protective factors for RLS, and smoking （OR=4031.32, 95% CI25.99～625413.34）, serum total protein （OR=1.40, 95% CI 1.02～ 1.92）, BUN （OR=1.59, 95% CI 1.19～2.52） and serum potassium （OR=8.86, 95% CI 1.39～56.38） were the risk factors for RLS. Conclusion The occurrence of RLS may relate to the coexistence of multivariate factors including personal factors, personal habits, nutrition condition, MHD effectiveness, and serum electrolytes.