腹膜透析患者尿毒症瘙痒症患病现状及其生活行为方式分析

Prevalence of uremic pruritus in patients with peritoneal dialysis and its association with life behaviors

目的了解腹膜透析患者尿毒症瘙痒症的患病现状及其生活行为方式, 并分析其对瘙痒和瘙痒严重程度的影响。方法采取横断面调查的方法, 于2023年10—12月选取杭州市中医院肾内科腹膜透析中心规律随访的腹透患者作为研究对象, 调查其一般临床资料、尿毒症瘙痒症患病情况、知晓情况、治疗情况, 以及吸烟、喝酒、饮食、洗澡、运动5种生活行为方式等, 根据是否伴发尿毒症瘙痒症症状分为瘙痒组及无瘙痒组, 比较两组患者一般资料及生活行为方式的差异;同时将瘙痒组患者根据瘙痒症状评分分为轻、中、重3组, 比较3组患者一般资料及生活行为方式的差异。结果共255例腹膜透析患者接受调查, 其中瘙痒患者144例(56.5%), 包括轻度瘙痒55例(38.2%), 中度瘙痒61例(42.4%), 重度瘙痒28例(19.4%)。患者对尿毒症瘙痒症的知晓率为22.2%(32/144), 治疗率为12.5%(18/144)。瘙痒组与无瘙痒组的洗澡情况(χ^(2)=7.03)、碱性洗澡用物应用情况(χ^(2)=6.47)比较差异有统计学意义(均P<0.05)。年龄≥60岁(Z=-3.13)、文化程度初中及以下(Z=-3.56)、饮水<500 ml/d(H=18.01)、嗜好辛辣及荤菜的(H=9.34)、洗澡大于3次/周(H=10.96)及经常应用碱性洗澡用物(H=6.57)的腹膜透析患者中, 中、重度瘙痒占比更高, 差异有统计学意义(均P<0.05)。结论腹膜透析患者尿毒症瘙痒症发生率高, 知晓率和治疗率低, 需要加强腹膜透析患者尿毒症瘙痒症的健康教育, 纠正其不良的生活行为方式及习惯, 以减少尿毒症瘙痒症的发生。

Objective:To investigate the prevalence of uremic pruritus(UP)in patients with peritoneal dialysis and its association with life behaviors.Methods:A total of 255 patients with peritoneal dialysis were followed up in Peritoneal Dialysis Center of Hangzhou Hospital of Traditional Chinese Medicine from October to December 2023 were enrolled.The general clinical data,disease awareness,treatment,and lifestyle behaviors(smoking,drinking,diet,bathing,and exercising etc)were compared between patients with or without UP,and among patients with different severity of UP.Results:Among 255 peritoneal dialysis patients,there were 144 UP cases with a prevalence rate of 56.5%,including 55 cases with mild itching(38.2%),61 cases with moderate itching(42.4%),and 28 cases with severe itching(19.4%).The awareness rate of UP was 22.2%(32/144),the treatment rate of UP was 12.5%(18/144).There were significant differences in bath frequency(χ^(2)=7.03),and using alkaline body wash(χ^(2)=6.47)between UP group and non-UP group(P<0.05).The severity of UP was associated with old age(≥60 years,Z=-3.13),low educational levels(primary school or lower,Z=-3.56),less water drinking(<500 ml/d,H=18.01),more spicy food and meat(H=9.34),bath more than 3 times per week(H=10.96),and using alkaline body wash(H=6.57)(all P<0.05).Conclusion:Peritoneal dialysis patients have a high incidence of UP and a low rate of knowledge and treatment,and it is necessary to strengthen the health education and to modify their life behaviors in order to reduce the incidence of UP.