老年维持性血液透析病人内在能力现状及影响因素分析

Analysis of status and influencing factors of intrinsic capacity in elderly patients receiving maintenance hemodialysis

目的探索老年维持性血液透析(maintenance hemodialysis,MHD)病人的内在能力(intrinsic capacity,IC)及其影响因素。方法采用方便抽样法,抽取东南大学附属中大医院血液净化中心2023年1—6月老年MHD病人。收集病人一般资料,并进行IC评估,评估内容包括采用简易躯体能力测试评估运动能力、采用微型营养评估简表评估营养状态、采用MMSE量表评估认知功能、采用Zung抑郁自评量表评估抑郁状态,并自述视力/听力下降评估感觉。结果本研究共调查老年MHD病人175例,平均年龄为(69.78±6.92)岁,其中男性105例(60.00%),平均透析龄为(66.91±55.36)个月,IC总平均得分为(2.25±1.03)分。其中,IC较好(≥3分)的老年MHD病人53例(30.29%)、IC欠佳(<3分)的老年MHD病人122例(69.71%)。多因素Logistic回归分析结果显示,血浆白蛋白是老年MHD病人IC的保护因素,年龄和β2微球蛋白是老年MHD病人IC的独立危险因素。结论老年MHD病人IC下降普遍存在,升高血浆白蛋白水平可能有益于提升老年MHD病人的IC。

Objective To explore the status and influencing factors of intrinsic capacity(IC)in the elderly patients receiving maintenance hemodialysis(MHD),and to provide evidence for improving the quality of life.Methods Convenience sampling was used to select the elderly MHD patients from the outpatient department of Blood Purification Center of Zhongda Hospital Southeast University from January to June 2023.The general information and clinical data of the patients were collected.The level of IC was evaluated,including the Short Physical Performance Battery(SPPB),Mini Nutritional Assessment short-form(MNA-SF),Mini-Mental State Examination(MMSE),Zung’s Self-rating Depression Scale and self-reported visual/hearing impairment.Results A total of 175 elderly MHD patients were enrolled in this study,with an average age of 69.78±6.92 years,with an average dialysis age of 66.91±55.36 months.Among them,there were 105 males(60.00%),53 cases(30.29%)with good IC(≥3 points)and 122 cases(69.71%)with poor IC(<3 points).The total average score of IC was 2.25±1.03 points.Multiple Logistic regression analysis showed that albumin was a protective factor,and age and β2-microglobulin were independent risk factors for IC in the elderly MHD patients.Conclusions The decline of IC is common in the elderly MHD patients,and high level of albumin could improve the level of IC in the patients.