本文關(guān)鍵詞：合肥市維持性血液透析患者不寧腿綜合征流行病學(xué)調(diào)查　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 不寧腿綜合征 血液透析 患病率 生活質(zhì)量 睡眠質(zhì)量 抑郁 焦慮

【摘要】：目的調(diào)查合肥市維持性血液透析患者不寧腿綜合征(restless legs syndrome,RLS)患病率及RLS相關(guān)危險因素;評估RLS對維持性血液透析患者生活質(zhì)量、睡眠質(zhì)量、抑郁及焦慮的影響。方法調(diào)查2013.12.1至2014.03.31在安徽醫(yī)科大學(xué)第二附屬醫(yī)院、合肥市第一人民醫(yī)院、安徽省第二人民醫(yī)院、合肥市第五人民醫(yī)院、武警安徽省總隊醫(yī)院血液凈化中心行血液透析的透析齡3個月或以上的成年患者;排除不愿意參與該調(diào)查、不能夠提供知情同意、不能進行正常交流、急性感染期、合并其他器官嚴重功能衰竭、帕金森病、癡呆癥、妊娠、昏迷、腫瘤患者。對符合條件的所有患者行面對面問卷調(diào)查,調(diào)查內(nèi)容包括一般人口學(xué)特點如性別、年齡,臨床資料如慢性腎衰竭原發(fā)病、透析齡、透析方式、RLS家族史,RLS診斷問卷、Zung抑郁自評量表(Self-Rating Depression Scale,SDS)、Zung焦慮自評量表(Self-Rating Anxiety Scale,SAS)、匹茲堡睡眠質(zhì)量指數(shù)(Pittsburgh Sleep Quality Index,PSQI)調(diào)查表、腎臟病和生活質(zhì)量問卷(kidney disease and quality of life,KDQOLTM-36),同時收集患者調(diào)查期間血液透析前臨床實驗室檢查數(shù)據(jù)。根據(jù)患者是否診斷為RLS將患者分為RLS+組和RLS-組,比較兩組患者之間一般人口學(xué)特征、臨床特點、實驗室檢查指標等有無差異;以是否診斷為RLS為結(jié)果變量,上述人口學(xué)特征、臨床特點、實驗室檢查指標為自變量,建立logistic多因素回歸模型,尋找血液透析患者合并RLS相關(guān)危險因素;比較RLS+組患者和RLS-組患者生活質(zhì)量、睡眠質(zhì)量、抑郁評分、焦慮評分的差異,了解RLS對血液透析患者的影響。結(jié)果1.符合條件人數(shù)269人,男性188人,女性81人,平均年齡51.8±14.3歲,中位透析齡33(12.5,69.0)月;2.診斷RLS 39人,RLS患病率為14.50%;根據(jù)單因素分析,RLS+組患者血紅蛋白濃度明顯低于RLS-組(98.67±13.50 VS 106.34±17.75g/l,P=0.011),堿性磷酸酶濃度明顯高于RLS-組(131.0(98.0,226.0)VS 94.0(69.8,157.5)u/l,P=0.001),兩組患者在性別、年齡、透析類型、透析齡、血鈣、磷、肌酐、尿素氮、鐵蛋白、轉(zhuǎn)鐵蛋白飽和度、全段甲狀旁腺激素、是否合并糖尿病、是否合并高血壓等方面差異均無統(tǒng)計學(xué)意義;根據(jù)Logistic回歸分析,高血紅蛋白濃度為RLS患病保護因素(OR:0.975,95%CI(0.956-0.995),P=0.015),高堿性磷酸酶濃度為RLS患病危險因素(OR:1.003,95%CI(1.001-1.005),P=0.018);3.睡眠質(zhì)量方面,RLS+患者PSQI總分(11.86±4.72 VS 7.90±4.39,P0.001)、主觀睡眠質(zhì)量(1.89±0.81VS 1.12±0.86,P0.001)、睡眠潛伏期(2.00±1.03VS 1.49±1.07,P0.007,)、睡眠持續(xù)時間(1.59±1.17 VS 0.90±1.01 P0.001)、習(xí)慣睡眠效率(1.89±1.29 VS 1.14±1.26,P=0.001)、睡眠干擾(2.50±0.51 VS 2.06±0.51,P0.001)、日間功能(1.62±0.95 VS 1.17±1.09,P=0.019)方面評分均明顯高于RLS-組患者;生活質(zhì)量方面,RLS+組在總體健康評分(32.64±16.71 VS 40.78±19.58,P=0.019)、社會情感評分(38.89±44.90 VS 58.99±44.62,P=0.013)、精力體力評分(37.78±26.09 VS 49.35±27.25,P=0.019)、癥狀影響評分(69.51±19.74VS82.17±15.06,P0.001)方面明顯低于RLS-組患者;RLS+患者抑郁自評分(45.28±10.35 VS 40.07±10.10,P=0.005)、焦慮自評分(37.61±8.75 VS 34.28±6.10,P=0.034)均明顯高于RLS-組患者。結(jié)論合肥市維持性血液透析患者RLS患病率為14.5%,高血紅蛋白濃度為RLS保護因素,高堿性磷酸酶濃度為RLS危險因素;不寧腿綜合征對血液透析患者睡眠質(zhì)量多個方面及生活質(zhì)量多個方面影響嚴重,且導(dǎo)致患者抑郁及焦慮程度重于非不寧腿綜合征患者。
[Abstract]:Objective to investigate Hefei hemodialysis patients with restless legs syndrome (restless legs syndrome, RLS RLS) prevalence and related risk factors; evaluation of RLS to maintain the quality of life in patients with hemodialysis affect sleep quality, depression and anxiety. Methods 2013.12.1 to 2014.03.31 in the Second Affiliated Hospital of Medical University Of Anhui, the first people's Hospital of Hefei City, Second People's Hospital of Anhui Province, the Fifth People's Hospital of Hefei City, the Armed Police Corps in Anhui province hospital blood purification center for hemodialysis at the age of 3 months or more adult patients; exclude the willingness to participate in the investigation, not to be able to provide informed consent, not the normal communication, acute infection period, combined with the other organ function seriously failure, Parkinson's disease, Alzheimer's disease, pregnancy, coma, cancer patients. All patients underwent investigation to meet the conditions of the face-to-face questionnaire, the survey includes general people Demographic characteristics such as gender, age, clinical data such as chronic renal failure of primary disease, dialysis, dialysis, RLS family history, RLS diagnostic questionnaire, Zung self rating Depression Scale (Self-Rating Depression Scale, SDS), Zung self rating Anxiety Scale (Self-Rating Anxiety Scale, SAS), Pittsburgh (sleep quality index Pittsburgh Sleep Quality Index, PSQI) questionnaire, kidney disease and quality of life questionnaire (kidney disease and quality of life, KDQOLTM-36), were collected during the investigation before hemodialysis clinical laboratory data. According to whether patients diagnosed as RLS were divided into RLS+ group and RLS- group. The clinical features of general demographic characteristics, comparison there is no difference between the two groups of patients, laboratory indicators; as to whether RLS was diagnosed as outcome variables, the demographic characteristics, clinical features, laboratory examination indexes as the independent variables, multiple factors to establish logistic To find the relative risk model of hemodialysis patients with RLS factors; comparison of patients in group RLS+ and group RLS- patients' quality of life, sleep quality, depression score, anxiety score differences, understand the effect of RLS on hemodialysis patients. Results 1. of the eligible population 269 people, 188 male, 81 female, the average age of 51.8. At the age of 14.3, median age 33 months of dialysis (12.5,69.0); 2. diagnosis of RLS 39, the prevalence rate of RLS was 14.50%; according to univariate analysis, patients in group RLS+ hemoglobin concentration was significantly lower than in group RLS- (98.67 + 13.50 VS 106.34 + 17.75g/l, P=0.011), the concentration of alkaline phosphatase was significantly higher than that of group RLS- (131 (98.0226.0) VS 94 (69.8157.5) u/l, P=0.001), the two groups in gender, age, dialysis, dialysis, serum calcium, phosphorus, creatinine, urea nitrogen, ferritin, transferrin saturation, parathyroid hormone, diabetes mellitus, hypertension etc. There were no significant differences; according to Logistic regression analysis, the high hemoglobin concentration is RLS in protective factor (OR:0.975,95%CI (0.956-0.995), P=0.015), high concentration of alkaline phosphatase was RLS risk factors (OR:1.003,95%CI (1.001-1.005), P=0.018); 3. patients with RLS+ sleep quality, the total score of PSQI (11.86 + 4.72 VS 7.90 + 4.39. P0.001), subjective sleep quality (1.89 + 1.12 + 0.86 0.81VS, P0.001), sleep latency (2 + 1.49 + 1.07 1.03VS, P0.007), sleep duration (1.59 + 1.17 VS 0.90 + 1.01 P0.001), habitual sleep efficiency (1.89 + 1.29 VS 1.14 + 1.26, P=0.001 (2.50), sleep disturbance 2.06 + 0.51 VS + 0.51, P0.001), daytime function (1.62 + 0.95 VS 1.17 + 1.09, P=0.019) score were significantly higher than that in RLS- group; RLS+ group in terms of quality of life, general health score (32.64 + 16.71 VS 40.78 + 19.58, P=0.019), social emotional score (38.89 58.99 + 44.90 VS + 44.62, P=0.013), physical energy score (37.78 + 26.09 VS 49.35 + 27.25, P=0.019), the symptoms affect the score (69.51 + 19.74VS82.17 + 15.06, P0.001) was significantly lower than group RLS- patients; depression in patients with RLS+ score (45.28 + 10.35 VS 40.07 + 10.10, P=0.005), self rating Anxiety Scale (37.61 + 8.75 VS 34.28 + 6.10, P=0.034) were significantly higher than those in group RLS- patients. Conclusion Hefei hemodialysis patients RLS prevalence rate was 14.5%, the high hemoglobin concentration is RLS protective factors, high concentration of alkaline phosphatase were risk factors for RLS; restless legs syndrome effects on many aspects of quality the quality of life of sleep in hemodialysis patients is serious, and the cause of depression and anxiety in patients with restless legs syndrome.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R459.5;R741

【參考文獻】

相關(guān)期刊論文 前1條

1 王玉姝;王紅月;竇海川;崔明姬;;高通量透析對尿毒癥血液透析患者不寧腿綜合征的療效[J];中國老年學(xué)雜志;2011年16期

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本文編號：1413658