尿毒症血液透析患者发生胃肠反应及营养不良的相关危险因素研究

Study on the risk factors of gastrointestinal reactions and malnutrition in uremic patients with hemodialysis

目的探讨尿毒症血液透析患者发生胃肠反应及营养不良的相关危险因素。方法96例尿毒症血液透析患者,按患者是否产生胃肠反应分为无胃肠反应组(26例)、有胃肠反应组(70例);按患者是否有营养不良情况分为无营养不良组(47例)、营养不良组(49例)。根据患者的临床资料及相关生化检查,分析尿毒症血液透析患者发生胃肠反应及营养不良的相关危险因素。结果多因素Logistic回归分析显示,年龄大、体质量指数(BMI)低、血红蛋白(Hb)低、服药片数多、使用糖皮质激素、透析时间长、残余肾尿素消除指数(kt/v)低、血清红细胞比容(HCT)低、甲状旁腺激素高、合并糖尿病为导致尿毒症血液透析患者发生胃肠道反应的危险因素(P<0.05)。年龄大、透析时间长、并发糖尿病、C反应蛋白(CRP)高、肺表面活性蛋白A(SPA)低、白蛋白(ALB)低、Hb低、总胆固醇(TC)低为导致尿毒症血液透析患者发生营养不良的危险因素(P<0.05)。结论在血液透析过程中分析患者产生胃肠反应及营养不良的危险因素,并对相关因素加以合理控制,有助于提高治疗效果并促进预后,意义重大,值得临床推广应用。

Objective To discuss the risk factors of gastrointestinal reactions and malnutrition in uremic patients with hemodialysis.Methods A total of 96 cases uremic patients with hemodialysis were divided into groups non-gastrointestinal reaction group(26 cases)and gastrointestinal reaction group(70 cases)according to whether the patients had gastrointestinal reactions or not;according to their malnutrition,they were divided into non-malnutrition group(47 cases)and malnutrition group(49 cases).Based on the patients’clinical data and relevant biochemical tests,the risk factors associated with the occurrence of gastrointestinal reactions and malnutrition in uremic patients with hemodialysis were analyzed.Results Multivariate Logistic regression analysis showed that older age,low body mass index(BMI),low hemoglobin(Hb),high number of pills taken,use of glucocorticoids,long dialysis time,low kt/v,low serum hematocrit(HCT),high parathyroid hormone,and concurrent diabetes mellitus were the risk factors for gastrointestinal reactions in uremic patients with hemodialysis(P<0.05).Older age,long dialysis time,concurrent diabetes mellitus,high C-reactive protein(CRP),low pulmonary surfactant protein A(SPA),low albumin(ALB),low Hb,low total cholesterol(TC)were risk factors for malnutrition in uremic patients with hemodialysis(P<0.05).Conclusion The analysis of risk factors for gastrointestinal reactions and malnutrition in patients during hemodialysis and the rational control of related factors can help improve the therapeutic effect and promote the prognosis.It is of great significance and worthy of clinical promotion and application.