尿毒症患者透析间期体重获得与生活质量的关系

Relationship between interdialytic weight gain and quality of life in hemodialysis patients

目的 研究血液透析患者透析间期体重获得量 (IDWG % )与患者营养状况、血压以及生活质量评分的关系。方法 连续观察 84例维持性血液透析患者 12周 ,记录患者的营养状况 (三角肌皮褶厚度、上臂肌肉面积、体重指数 )、透析充分性 (Kt/V)、标准蛋白分解率 (nPCR)和血压变化 ,进行生活质量SF - 36问卷调查。分析IDWG %与上述指标的相关性。并按不同的IDWG %将患者分组 ,比较组间差异。结果 IDWG %平均值为 (6 .8± 2 .7) %。IDWG %与患者的三角肌皮褶厚度、上臂肌肉面积、体重指数、Kt/V、nPCR、SF - 36体能综合评分、SF - 36精神综合评分呈正相关 ;IDWG %与干体重呈负相关 ;ID WG %透析前平均动脉压、透析血压下降率无相关性。分组比较表明 ,IDWG % >8%的患者 ,透析中血压下降的发生率增大。结论 在一定范围内 ,高水平的IDWG %伴随好的营养状况和生活质量 ,并且对血压影响不大。对透析患者水的限制应该个体化 ,以提高患者的生活质量。

Objective To determine the relationship between interdialytic weight gain(IDWG%) and the quality of life in hemodialysis patients.Methods We studied 84 stable hemodialysis patients over a 12-week period to track record of anthropometrics measurements, biochemical data and blood pressure changes during hemodialysis. Medical Outcome Study Short Form-36 was administered to evaluate patients' subjective sense of well-being. Results The mean IDWG% was 6.8%±2.7%. A positive correlation were found between IDWG% and triceps skinfold thickness, arm muscle area, body mass index, Kt/V, nPCR, Physical Components Scale and Mental Component Scale. A negative correlation was found between IDWG% and dry weight. There was no correlation between IDWG% and blood pressure. But in group with IDWG% more than 8%, the rate of blood pressure decrease during dialysis was much higher.Conclusions In a certain extension, a greater IDWG% is associated with higher nutritional status and higher self sense of well-being, but not associated with hypertension. IDWG% greater than 8% can cause blood pressure decrease during hemodialysis.