糖尿病肾病维持性血液透析患者皮肤瘙痒发生的影响因素分析

Influencing factors of pruritus in patients undergoing hemodialysis for diabetic nephropathy

目的探讨糖尿病肾病维持性血液透析患者皮肤瘙痒发生的影响因素。方法前瞻性抽取2021年5月至2023年5月于郑州大学第一附属医院接受维持性血液透析治疗的糖尿病肾病患者198例为研究对象,观察糖尿病肾病患者维持性血液透析期间皮肤瘙痒发生情况,并根据结果分为发生组和未发生组。收集两组患者的一般资料和主要实验室指标检测结果,采用单因素和多因素Logistic回归分析检验糖尿病肾病患者维持性血液透析期间皮肤瘙痒发生的影响因素。结果198例行维持性血液透析治疗的糖尿病肾病患者中,发生皮肤瘙痒108例,发生率为54.55%,纳入发生组;90例未发生皮肤瘙痒的患者纳入未发生组。发生组与未发生组年龄、糖尿病病程、血液净化方式、空腹血糖(FBG)水平、尿素清除指数(Kt/v)水平比较差异均有统计学意义(P均<0.05)。经多因素Logistic回归分析结果显示,年龄大、糖尿病病程长、血液净化方式为单纯血液透析、FBG水平高是糖尿病肾病维持性血液透析皮肤瘙痒发生危险因素(OR>1),Kt/v水平高是其保护因素(OR<1)。结论糖尿病肾病维持性血液透析患者并发皮肤瘙痒的风险高,可能与年龄、糖尿病病程、血液净化方式、FBG水平、Kt/v水平有关,临床应予以重视。

Objective To investigate the influencing factors of pruritus in patients undergoing hemodialysis for diabetic nephropathy.Methods A total of 198 patients treated by hemodialysis for diabetic nephropathy in the First Affiliated Hospital of Zhengzhou University from May 2021 to May 2023 were prospectively selected as research subjects.The occurrence of pruritus during maintenance hemodialysis was observed.And they were divided into an occurrence group and a non-occurrence group according to the occurrence of pruritus observed.General information and results of major laboratory indicator testings were collected from the two groups.Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of pruritus during maintenance hemodialysis in patients with diabetic nephropathy.Results Among the 198 patients who underwent maintenance hemodialysis for diabetic nephropathy,108 cases experienced pruritus,with an incidence of 54.55%,and they were included in the occurrence group;90 patients who did not experience pruritus were included in the non-occurrence group.There were significant differences in age,course of diabetes,blood purification mode,fasting blood glucose(FBG)level,and urea clearance index(Kt/v)between the occurrence group and the non-occurrence group(all P<0.05).Univariate and multivariate logistic regression analyses revealed that older age,long course of diabetes,simple hemodialysis as blood purification mode,high FBG level were the risk factors for pruritus in patients with maintenance hemodialysis for diabetic nephropathy(OR>1),moreover,high Kt/v level was the protective factor(OR<1).Conclusions The risk of pruritus in diabetic nephropathy patients with maintenance hemodialysis is high,which may be related to age,course of diabetes,blood purification mode,FBG level and Kt/v level.It should be paid attention to in clinical.