维持性血液透析患者症状特征潜在剖面分析和影响因素研究

An analysis of the latent classification and influencing factors of the characteristic symptoms in patients with maintenance hemodialysis

目的探讨维持性血液透析患者症状特征的潜在亚组及其影响因素。方法采用便利抽样法,选取2023年11月至2024年4月于陕西省中医医院血透室进行血液透析治疗的患者,使用一般资料问卷、透析症状困扰量表进行调查,使用Mplus 8.3软件进行潜在剖面分析,使用二元Logistic回归分析探讨分类的影响因素。结果共纳入211例维持性血液透析患者,根据症状特征可分为低症状负担组(39%)和高症状负担组(61%)两个组别。回归分析结果显示,性别[OR=0.189,95%CI(0.080,0.446)]、年龄[OR=1.085,95%CI(1.048,1.124)]和血钠水平[OR=0.862,95%CI(0.774,0.959)]是患者症状特征亚组类别的影响因素(P<0.05)。结论维持性血液透析患者症状特征存在异质性,可分为2个潜在亚组,后续医护人员应加强关注女性、高龄以及血钠水平低于138.46 mmol/L的患者。

Objective To explore the potential subgroups of symptom characteristics and their influencing factors in maintenance hemodialysis(MHD)patients.Methods Patients with MHD in the hemodialysis department of Shaanxi Provincial Hospital of Chinese Medicine from November 2023 to April 2024 were selected by convenience sampling method,and survyed with the general data questionnaire and Dialysis Symptom Index.Mplus 8.3 was used for latent profile analysis of group symptoms,and binary Logistic regression was used to analyze the influencing factors of symptoms group.Results A total of 211 cases of MHD patients were included and divided into two groups:low symptom burden group(39%)and high symptom burden group(61%)according to their symptom characteristics.The results of regression analysis showed that gender[OR=0.189,95%CI(0.080,0.446)],age[OR=1.085,95%CI(1.048,1.124)]and serum sodium[OR=0.862,95%CI(0.774,0.959)]were the influencing factors that distinguished the two subgroups(P﹤0.05).Conclusion There is heterogeneity in the symptom characteristics of MHD patients,which can be divided into two potential subgroups.Medical staff should pay more attention to female patients,elderly patients,and patients with serum sodium levels less than 138.46 mmol/L.