低握力是维持性血液透析患者感染性疾病住院的危险因素

Low handgrip strength is a risk factor for hospitalization for infectious diseases in maintenance hemodialysis patients

目的:探讨维持性血液透析(MHD)患者握力与感染性疾病住院风险的关系。方法:回顾性分析2019年9月在广州市红十字会医院血液透析中心MHD患者151名。收集患者的基本资料,包括临床资料、握力、营养情况及生化指标。收集1年内患者的住院情况及住院原因。应用Logistic回归分析MHD患者住院及感染性疾病的危险因素。结果:151名MHD患者1年内有96例患者住院,单因素分析显示,性别、年龄、血肌酐、透析龄、握力、淋巴细胞计数及合并冠心病是影响MHD患者住院的危险因素。多因素Logistic回归分析显示透析龄(OR=0.984,95%CI:0.973~0.995)、握力(OR=0.952,95%CI:0.915~0.990)及淋巴细胞计数(OR=0.270,95%CI:0.099~0.738)为MHD患者住院事件的3个独立影响因素。低握力组感染性疾病的发生率(33.33%)高于高握力组(13.16%,P=0.003),低握力是感染性疾病独立危险因素(OR=2.976,95%CI:1.302~6.801,P=0.010)。结论:透析龄、握力及淋巴细胞计数是MHD患者住院的独立影响因素。低握力是MHD患者因感染性疾病住院事件的独立危险因素。

Objective:To explore the relationship between handgrip strength and the risk of hospitalization for infectious diseases in maintenance hemodialysis(MHD) patients. Methods: A retrospective analysis of 151 patients with maintenance hemodialysis in the hemodialysis center of Guangzhou Red Cross Hospital in September 2019. The base data including clinic data, handgrip strength, nutrient data and biochemical measurement were collected. The frequency of hospitalization and reason for hospitalization were gathered in the first year after the testing handgrip strength. Logistic regression was used to explore risk factors of hospitalization and infectious disease in MHD patients. Results: Ninety-six of the 151 patients with MHD were hospitalized in 1 year, and univariate analysis showed that sex, age, creatinine, dialysis age, handgrip strength, lymphocyte count, and coronary heart disease were risk factors affecting the hospitalization of patients with MHD. Multivariate Logistic regression analysis showed that dialysis age(OR=0.984, 95% CI: 0.973~0.995), handgrip strength(OR=0.952, 95% CI: 0.915~0.990), and lymphocyte count(OR=0.270, 95% CI: 0.099~0.738) were three independent influencing factors for the hospitalization of patients with MHD. The incidence of infectious diseases was higher in the low handgrip strength group than in the high handgrip strength group(33.33% vs 13.16%, P=0.003), and low handgrip strength was an independent risk factor for infectious disease(OR=2.976, 95% CI: 1.302~6.801, P=0.010). Conclusion:Dialysis age, handgrip strength and lymphocyte count are independent influencing factors of hospitalization of patients with MHD. Low handgrip strength is an independent risk factor for hospitalizations of patients with MHD due to infectious disease.