本文關(guān)鍵詞： 腹膜透析 肺淤血 生活質(zhì)量 肺超聲 慢性腎功能衰竭　出處：《山東醫(yī)藥》2017年22期 　論文類(lèi)型：期刊論文

【摘要】：目的觀察維持性腹膜透析患者肺淤血及生活質(zhì)量情況,并探討兩者的關(guān)系。方法收集105例維持性腹膜透析患者的相關(guān)臨床資料,應(yīng)用肺超聲顯示的B線數(shù)目評(píng)估肺淤血,采用簡(jiǎn)明健康調(diào)查問(wèn)卷(SF-36)評(píng)估生活質(zhì)量,計(jì)算軀體健康總分(PCS)與精神健康總分(MCS)。采用Spearman相關(guān)分析B線數(shù)目與PCS、MCS的相關(guān)性。按PCS、MCS的中位數(shù)值將患者分為高PCS者與低PCS者、高M(jìn)CS者與低MCS者,并比較兩者相關(guān)指標(biāo)的差異,采用logistic回歸分析確定生活質(zhì)量的獨(dú)立影響因素。結(jié)果 105例患者B線數(shù)目為4(0,17)條,存在肺淤血52例,PCS為52.8(44.8,59.8)分、MCS為54.5(46.8,60.8)分。B線數(shù)目與PCS、MCS呈負(fù)相關(guān)(r分別為-0.589、-0.464,P均0.01)。與高PCS者相比,低PCS者B線數(shù)目、血B型尿鈉肽、年齡、糖尿病腎病比例和心腦血管疾病史比例高(P均0.05),血紅蛋白、血白蛋白低(P均0.01)。與高M(jìn)CS者相比,低MCS者B線數(shù)目、血B型尿鈉肽高(P均0.01),血紅蛋白、血白蛋白低(P均0.01)。多因素分析結(jié)果顯示,B線數(shù)目、血紅蛋白水平、年齡及心腦血管疾病史是PCS的獨(dú)立影響因素(P均0.05),但僅前兩者是MCS的獨(dú)立影響因素(P均0.05)。結(jié)論維持性腹膜透析患者肺淤血發(fā)生率較高且生活質(zhì)量較低。肺淤血可能是患者生活質(zhì)量下降的重要原因。
[Abstract]:Objective to observe the pulmonary congestion and quality of life (QOL) in patients with maintenance peritoneal dialysis (MPD) and to explore the relationship between them. Methods the clinical data of 105 patients with maintenance peritoneal dialysis (MPD) were collected. Pulmonary congestion was assessed by the number of B-line ultrasound and quality of life (QOL) was evaluated by SF-36 (a brief health questionnaire). Spearman correlation analysis was used to analyze the correlation between the number of line B and the total score of mental health. The correlation between the number of line B and MCS was analyzed by PCS. The median value of MCS was divided into high PCS patients and low PCS patients, high MCS patients and low MCS patients. Logistic regression analysis was used to determine the independent influencing factors of quality of life. Results the number of B lines in 105 patients was 4 0 / 17 and pulmonary congestion was found in 52 cases. The number of line B was negatively correlated with PCS (P < 0. 589, P < 0. 05). Compared with those with high PCS, the patients with low PCS had the number of B-line, type B urine natriuretic peptide and age. The proportion of diabetic nephropathy and the history of cardio-cerebrovascular disease were both 0.05, hemoglobin and serum albumin were all 0.010.Compared with the high MCS, the number of B-line in the patients with low MCS was lower than that in the patients with high MCS. Urine natriuretic peptide of type B was 0.01g, hemoglobin and serum albumin were 0.010.Multivariate analysis showed the number of B line and the level of hemoglobin. Age and history of cardiovascular and cerebrovascular diseases were independent influencing factors of PCS (P < 0.05). However, only the former two factors are independent factors of MCS (P < 0.05). Conclusion the incidence of pulmonary congestion and quality of life in patients with maintenance peritoneal dialysis are higher and lower, and pulmonary congestion may be an important reason for the decline of quality of life.
【作者單位】： 汕頭市中心醫(yī)院;
【基金】：廣東省醫(yī)學(xué)科研基金項(xiàng)目(B2016115)
【分類(lèi)號(hào)】：R692.5
【正文快照】： 終末期腎臟病患者盡管可接受維持性透析治療,但其生活質(zhì)量仍顯著低于普通人群。已有研究發(fā)現(xiàn),維持性透析患者生活質(zhì)量下降的危險(xiǎn)因素有微炎癥、營(yíng)養(yǎng)不良、殘余腎功能等,但因研究人群、研究方法、文化、經(jīng)濟(jì)等不同而缺乏一致性結(jié)論[1~3]。維持性透析患者水鈉潴留可引起容量超負(fù)

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