【摘要】：目的:通過研究非透析慢性腎臟病患者貧血對生存質(zhì)量的影響因素,探討糾正患者的貧血狀況是否可以改善患者的軀體癥狀以及患者的心理健康狀態(tài),從而提高患者的生存質(zhì)量。方法:入選2015年10月至2016年2月吉林大學(xué)第二醫(yī)院診斷為慢性腎臟病且為非透析的患者79例,記錄年齡、性別、原發(fā)病、生化指標(如血紅蛋白濃度、血清鐵濃度、轉(zhuǎn)鐵蛋白飽和度、鈣、磷、PTH、肌酐等)臨床資料,并需要受試者完成KDQOLTM-SF中簡化的SF-36量表調(diào)查問卷,SF-36量表中包含健康相關(guān)生存質(zhì)量的8個維度:生理功能、生理職能、情感職能、社會功能、軀體疼痛、精力、一般健康狀態(tài)、精神健康,通過讓受試者完成每個維度相關(guān)測評后計算各個維度分數(shù),最后應(yīng)用統(tǒng)計學(xué)分析方法綜合分析數(shù)據(jù)以評估患者生存質(zhì)量。結(jié)果:1.入選的79例患者中,男性42例(占53%),女性37例(占47%),男女比例約為:1.14:1。根據(jù)年齡段可劃分為青年組(45歲),中年組(45~64歲),和老年組(≥65歲),平均年齡62.2±15.3歲。其中青年組13例(占16.4%),中年組29例(占36.6%),老年組37例(占47%)。2.從腎臟病發(fā)病原因看,糖尿病性腎病居多(占44.3%),其次為原發(fā)腎臟疾病(如慢性腎小球腎炎、慢性間質(zhì)性腎炎、腎病綜合征等)。根據(jù)受試者血紅蛋白情況,把血紅蛋白正常的患者作為對照組;貧血的患者按實際貧血程度劃分為2組:輕度貧血組(90g/LHb110g/L),中度貧血組(60g/LHb90g/L)。3.分析3組患者SF-36健康調(diào)查量表分數(shù),從對照組到中度貧血組得分逐漸減少,其中對照組與中度貧血組對比差異有統(tǒng)計學(xué)意義(P0.05)。從總體上看,3組SF-36各個生存質(zhì)量相關(guān)維度中精神健康狀態(tài)得分偏高,其次為軀體疼痛和社會功能,而3組中生理職能、一般健康狀態(tài)、精力等維度得分偏低。4.將3組患者SF-36得分兩兩配對多重對比分析,結(jié)果為:對照組與輕度貧血組,輕度貧血組與中度貧血組,以上配對組的P值為0.047,小于0.05,差異有統(tǒng)計學(xué)意義;對照組與輕度貧血組,對照組與中度貧血組,以上配對組的P值為0.315,差異無顯著統(tǒng)計學(xué)意義;對照組與中度貧血組,輕度貧血組與中度貧血組,以上配對組的P值為0.293,差異無顯著性統(tǒng)計學(xué)意義。5.分析血紅蛋白與SF-36各個維度相關(guān)性,結(jié)果表明受試者SF-36各個維度得分與血紅蛋白水平呈正相關(guān),P值均小于0.01。結(jié)論:1.CKD患者出現(xiàn)貧血并發(fā)癥時最先容易影響到生存質(zhì)量中生理職能、一般健康狀態(tài)、精力等維度,對精神健康、軀體疼痛和社會功能影響較小。2.CKD貧血患者生存質(zhì)量受貧血程度影響,與血紅蛋白水平呈正相關(guān)。3.CKD貧血患者當貧血程度達到中度時,開始對生存質(zhì)量有顯著影響。
[Abstract]:Objective: to study the influencing factors of anemia on quality of life in patients with non-dialysis chronic kidney disease, and to explore whether correcting anemia can improve the physical symptoms and mental health of patients. In order to improve the quality of life of patients. Methods: from October 2015 to February 2016, 79 patients with chronic kidney disease and non-dialysis were enrolled in the second Hospital of Jilin University. Age, sex, primary disease and biochemical indexes (such as hemoglobin concentration, serum iron concentration) were recorded. Clinical data of transferrin saturation, calcium, phosphorus, PTH, creatine, etc., and subjects were required to complete the simplified SF- 36 questionnaire in KDQOLTM-SF. SF- 36 scale contained eight dimensions of health-related quality of life: physiological function. Physical function, emotional function, social function, physical pain, energy, general health status, mental health, by allowing the subjects to complete the relevant evaluation of each dimension to calculate the scores of each dimension, Finally, the statistical analysis method was used to evaluate the quality of life of the patients. Result: 1. Of the 79 patients selected, 42 were males (53%) and 37 were females (47%). The ratio of male to female was about 1.14%. According to the age group, it can be divided into youth group (45 years old), middle age group (45 鈮，

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