女性终末期肾病患者性功能障碍与腹膜透析充分性的相关性研究

Correlation between sexual dysfunction and adequacy of peritoneal dialysis in female patients with end-stage renal disease

目的探讨女性终末期肾病患者性功能障碍(SD)与腹膜透析(PD)充分性的相关性。方法选取2013年1月至2020年8月在绍兴第二医院医共体总院确诊为终末期肾病且行PD的126例女性患者为研究对象,根据女性性功能指数(FSFI)评测结果,SD 107例,性功能正常(非SD)19例;比较SD与非SD患者血液检查及透析相关指标,分析血液检查及透析相关指标与FSFI评分的相关性。结果女性PD患者SD发生率为84.9%。与非SD组比较,SD组血CRP、TG、肌酐、尿素氮、甲状旁腺激素水平均明显升高,Hb、血白蛋白水平以及24 h尿量、总尿素清除指数(Kt/V)、残肾Kt/V、残余肾功能(RRF)均明显降低,差异均有统计学意义(均P<0.05);而TC、血钙、血磷以及24 h超滤量、总肌酐清除率(Ccr)比较,差异均无统计学意义(均P>0.05)。女性PD患者血CRP、TG水平与FSFI各因子评分及总分均呈负相关(均P<0.05),血甲状旁腺激素水平与性欲评分及总分均呈正相关(均P<0.05),血尿素氮水平与性欲评分呈正相关(P<0.05),总Kt/V、总Ccr、RRF等透析相关指标与FSFI各因子评分及总分均呈正相关(均P<0.05)。结论女性终末期肾病患者SD发生率较高,与透析充分性密切相关。

Objective To explore the relationship between sexual dysfunction(SD)and adequacy of peritoneal dialysis(PD)in female patients with end-stage renal disease.Methods A total of 126 female patients with end-stage renal disease undergoing PD in the General Hospital of Shaoxing Second Hospital from January 2013 to August 2020 were enrolled in the study.According to the results of the female sexual function index(FSFI),there were 107 patients with SD and 19 patients normal sexual function(non-SD).The blood testing results and dialysis-related indicators were compared between SD and non-SD patients,and the correlation of blood tests and dialysis-related indicators with FSFI score was analyzed.Results The incidence of SD in female PD patients was 84.9%.Compared with the non-SD group,the blood CRP,TG,creatinine,urea nitrogen,and parathyroid hormone levels in the SD group were significantly increased,Hb,albumin levels,24-hour urine output,total urea clearance index(Kt/V),residual kidney Kt/V and residual renal function(RRF)were significantly reduced(all P<0.05),while there were no significant differences in TC,blood calcium,blood phosphorus,24-hour ultrafiltration volume,total creatinine clearance rate(Ccr)between two groups(all P>0.05).The blood CRP and TG levels of female PD patients were negatively correlated with the FSFI factor scores and total scores(all P<0.05),and the blood parathyroid hormone levels were positively correlated with the libido scores and total scores(all P<0.05).The level of urea nitrogen was positively correlated with the libido score(P<0.05),and the total Kt/V,total Ccr,RRF and other dialysis-related indicators were positively correlated with the FSFI factor scores and total scores(all P<0.05).Conclusion The incidence of SD in women with end-stage renal disease is higher,which is closely related to dialysis adequacy.