不同肾替代治疗下患者营养不良与生命质量的相关性研究

Study on the correlation between malnutrition and quality of life in patients with different renal replacement therapy

目的评价不同肾替代治疗方式下患者营养状况与生命质量的相关性。方法选取云南省两家三甲医院的168名尿毒症患者,按1∶1∶1匹配血透、腹透、肾移植患者,采用SF-36量表评价生命质量,改良的主观整体评估表评价营养状况。结果营养正常组、轻至中度营养不良组、重度营养不良组的生命质量评分分别为81.53±13.22分、61.86±17.20分、48.65±14.14分,差异均有统计学意义(P<0.05)。肾移植组的生命质量明显高于血透组和腹透组(P<0.05)。多元线性回归分析示:年轻、无并发症、肾移植、营养状况好与躯体健康评分显著相关;患者有工作、肾移植和营养状况好与心理健康评分显著相关。结论尿毒症患者的生命质量与营养状况、肾替代治疗方式相关,营养状况评估应成为尿毒症患者重要的监测指标。

Objectives To evaluate the correlation between malnutrition and quality of life in patients with end-stage renal disease(ESRD)who undergo a different type of renal replacement therapy.Methods A total of 168 uremia patients were selected from two top three hospitals,and matched by 1∶1∶1 with hemodialysis(HD),peritoneal dialysis(PD),and renal transplantation(RT),evaluated quality of life by SF-36 scale and the nutriture by modified subjective global assessment scale.Results The quality of life score of normal nutrition,mild to moderate malnutrition,and severe malnutrition group was 81.53±13.22,61.86±17.20,and 48.65±14.14,respectively,there was statistical significance in the difference(all P<0.05).Moreover,the score in RT group was significant higher compared to HD group and PD group(P<0.05).Multiple linear regressions revealed that there were significant correlation with the score of young age,no complications,renal transplantation,high-nutritional status and physical health;There were significant correlation with the patient was in work,renal transplantation,high nutritional status and mental health.Conclusions The quality of life of uremic patients is related to nutritional status and renal replacement therapy.The evaluation of the nutritional status in uremia patients should be an essential part of the monitoring index.