血液透析患者合并不宁腿综合征的危险因素

Risk factors for restless leg syndrome in hemodialysis patients

目的探讨血液透析患者合并不宁腿综合征(restless leg syndrome,RLS)的危险因素。方法回顾性收集2019年12月至2021年6月于郑州大学第一附属医院诊治的血液透析患者148例,其中合并RLS 40例,未合并RLS 108例。比较合并RLS组和未合并RLS组患者间临床特征及血清实验室检查指标之间的差异,采用多因素Logistic回归分析影响血液透析患者合并RLS的危险因素,对影响血液透析患者发生RLS的独立危险因素绘制受试者工作特征(ROC)曲线。结果与未合并RLS组比较,合并RLS组患者体重指数(BMI)高,透析持续时间长,合并高血压发生率高(均P<0.05),血清铁蛋白、甲状旁腺激素水平降低,铁调素、葡萄糖、C反应蛋白水平升高(均P<0.05);多因素Logistic回归分析结果显示铁调素、合并高血压是血液透析患者发生RLS的独立危险因素;ROC曲线分析显示铁调素、合并高血压对血液透析患者发生RLS具有预测价值,其中铁调素的准确性(曲线下面积为0.933)及灵敏度(95.0%)较高。结论铁调素水平高、合并高血压的血液透析患者应警惕RLS的发生,及早识别RLS并给予及时治疗,可提高血液透析患者的生活质量。

Objective To investigate the risk factors for restless legs syndrome in hemodialysis patients.Methods 148 hemodialysis patients diagnosed and treated in the First Affiliated Hospital of Zhengzhou University from December 2019 to June 2021 were collected retrospectively,including 40 cases with RLS and 108 cases without RLS.The differences of clinical characteristics and serum laboratory indices between hemodialysis patients with RLS and patients without RLS were compared.Multivariate logistic regression was used to analyze the risk factors for RLS,and the receiver operating characteristic(ROC)curve was performed for the independent risk factors of RLS in hemodialysis patients.Results Compared with the group without RLS,the patients with RLS had a higher body mass index(BMI),longer dialysis duration,higher incidence of hypertension(all P<0.05),and lower levels of serum ferritin and parathyroid hormone,as well as higher levels of hepcidin,glucose and C-reactive protein(all P<0.05).Multivariate logistic regression analysis showed that hepcidin and hypertension were independent risk factors for RLS in hemodialysis patients.ROC curve analysis showed that hepcidin and hypertension had predictive value for the RLS in hemodialysis patients,and hepcidin had high accuracy(area under the curve 0.933)and sensitivity(95.0%).Conclusions Hemodialysis patients with high levels of hepcidin and hypertension should be alert to the occurrence of RLS.Early identification and timely treatment can improve the quality of life of hemodialysis patients.