肾移植术后受体的疲乏状况及其相关因素

Status of fatigue in the receptor after renal transplantation and its related factors

目的:探讨肾移植术后受体疲乏状况及其相关因素。方法:通过横断面研究对我院137例肾移植受体进行调查,收集年龄、性别、婚姻状况、文化程度、经济收入、BMI、肾移植术后时间等一般资料,疲乏严重度量表(fatigue severity scale,FSS)评估受体疲乏状况,综合医院焦虑抑郁量表(hospital anxiety and depression,HAD)评估受体焦虑、抑郁状况,匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评估受体睡眠质量。采用单因素分析影响疲乏的相关因素,通过Pearson相关性分析FSS评分与各指标的相关性。结果:本组肾移植受体移植术后3~36(平均17.3)个月,疲乏发生率为59.1%(81/137)。女性(χ~2=5.655,P=0.017)、老年(χ~2=4.188,P=0.041)、较低经济收入(χ~2=4.747,P=0.029)、较高BMI(χ~2=4.663,P=0.031)、焦虑(χ~2=6.267,P=0.012)、抑郁(χ~2=1 0.0 9 7,P=0.0 0 1)、睡眠质量差(χ~2=7.3 5 1,P=0.0 0 7)与肾移植术后受体疲乏的发生相关。多因素logistic回归分析发现,只有抑郁(OR=0.35,95%CI:0.22~0.67,P=0.021)和睡眠质量(OR=0.52,95%CI:0.36~0.88,P=0.015)是肾移植术后受体疲乏的独立影响因素。肾移植术后受体FSS评分与HAD-A(r=0.318,P=0.037),HAD-D(r=0.675,P=0.012)评分呈显著正相关,与PSQI(r=-0.453,P=0.025)评分呈显著负相关。结论:肾移植术后受体仍可能遭受疲乏的困扰,并与焦虑、抑郁及睡眠质量等因素相关,今后应加强对疲乏的评估和干预。

Objective： To investigate the status of fatigue in renal transplant recipients and its related factors. Methods： A cross-sectional study of 137 cases of renal transplantation in our hospital were investigated. The general data of age, sex and marital status, education level, income and body mass index （BMI） of patients after renal transplantation time was investigated. The receptor fatigue status was evaluated using fatigue severity scale （FSS）. The anxiety and depression were assessed by hospital anxiety and depression （HAD） scale. The sleep quality was evaluated through Pittsburgh sleep quality index （PSQI）. The related factors of fatigue were analyzed by single factor analysis, and the correlation between FSS score and other indexes were analyzed by Pearson correlation analysis. Results： The incidence of fatigue was 59.1% （81/137） in 17.3 （3–36） months after renal transplantation. Female （χ^2=5.655, P=0.017） and the elderly （χ^2=4.188, P=0.041）, low income （χ^2=4.747, P=0.029）, higher body mass index （χ^2=4.663, P=0.031）, anxiety （χ^2=6.267, P=0.012）, depression （χ^2=10.097, P=0.001）, and poor sleep quality （χ^2=7.351, P=0.007） was correlation with fatigue after renal transplantation. Multivariate logistic regression analysis showed that only depression （OR=0.52, 95% CI： 0.36–0.88, P=0.015） and sleep quality （OR=0.52, 95% CI： 0.36–0.88, P=0.015） were independent factors influencing receptor fatigue after renal transplantation. The score of FSS has a positive correlation with HAD-A （r=0.318, P=0.037） and HAD-D （r=0.675, P=0.012）, and negative correlation with PSQI （r=-0.453, P=0.025）. Conclusion： The recipients may still suffer from fatigue after renal transplantation, and the fatigue is related to anxiety, depression and quality of sleep. Therefore, the assessment and intervention of fatigue should be strengthened in the future.