| 摘要: |
| 目的 调查维持性血液透析（MHD）患者骨骼肌减少症（以下简称肌少症）、生活质量及心理状况的现状，探讨患者肌少症与其生活质量、心理状况的关系。方法 根据欧洲老年肌少症工作组制订的诊断标准将2017年12月在我院接收治疗的101例MHD患者分为肌少症组（51例）和无肌少症组（50例）。所有入组患者均应用人体成分分析仪进行人体成分测量，用SF-36简明健康量表进行生活质量评估，用医院焦虑和抑郁量表（HADS）进行焦虑和抑郁情况评估。采用多元线性回归分析探讨MHD患者肌少症与其生活质量、心理状况的关系。结果 两组患者在年龄、性别、体质量指数（BMI）、Charlson合并症指数、握力、行走速度、体细胞质量、细胞外水分率（ECF/TBF）、高敏C-反应蛋白（hsCRP）、尿素清除指数（Kt/V）、焦虑、抑郁、生理功能、躯体疼痛、一般健康状况和精神健康方面的差异均有统计学意义（P<0.05，P<0.01），而在婚姻状况、受教育程度、年收入、透析龄、原发病、血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、前白蛋白、白蛋白、血钙、血磷、全段甲状旁腺激素、生理职能、精力、社会功能、情感职能方面的差异均无统计学意义（P均>0.05）。多元线性回归分析结果显示，骨骼肌质量、婚姻状况、合并症是伴肌少症MHD患者生活质量的影响因素（P均<0.05），而骨骼肌质量、BMI、年收入是伴肌少症MHD患者心理状况的影响因素（P<0.05，P<0.01）。结论 MHD患者中肌少症发病率较高。肌少症与较差的生活质量以及焦虑、抑郁症状之间有相关性，突出了早期发现并重视肌少症的重要性。 |
| 关键词: 维持性血液透析 骨骼肌减少症 生活质量 心理状况 |
| DOI：10.16781/j.0258-879x.2019.05.0577 |
| 投稿时间：2019-02-14修订日期：2019-03-14 |
| 基金项目: |
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| Relationship between skeletal muscle reduction and quality of life and mental status in maintenance dialysis patients |
| ZHANG Xiao-tong,XIAO Feng-lin,XUAN Fang,GAO Dong-mei,ZHAO Jun,LI Ming-xu* |
(Department of Nephrology, Naval Clinical College of Anhui Medical University(Sixth Medical Center of General Hospital of PLA), Beijing 100048, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the current status of skeletal muscle reduction (abbreviated as sarcopenia), quality of life and mental status of maintenance dialysis (MHD) patients, and to explore the relationship between sarcopenia and the quality of life and mental status. Methods According to the diagnostic criteria developed by the European Working Group on Sarcopenia in Older People, 101 MHD patients treated in our hospital in Dec, 2017 were divided into sarcopenia group (n=51) and non-sarcopenia group (n=50). The body composition was measured by human body composition monitor in all the patients. The quality of life was assessed using the SF-36 scale. The anxiety and depression were assessed with the hospital anxiety and depression scale (HADS). Multivariate linear regression analysis was used to explore the relationship between sarcopenia and the quality of life and mental status of the MHD patients. Results There were significant differences in the age, gender, body mass index (BMI), Charlson comorbidity index, grip strength, walking speed, somatic cell mass, extra-cellular fluid/total body fluid ratio (ECF/TBF), high-sensitivity C-reactive protein (hsCRP), urea clearance index (Kt/V), anxiety, depression, physical function, bodily pain, general health status and mental health between the two groups (P<0.05, P<0.01). While there were no significant differences in the marital status, education, annual income, dialysis age, primary disease, hemoglobin, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, prealbumin, albumin, serum calcium, blood phosphorus, intact parathyroid hormone, physical role, vitality, social function and emotion role between the two groups (all P>0.05). Multivariate linear regression analysis showed that skeletal muscle mass, marital status and comorbidity were the influencing factors of the quality of life of MHD patients with sarcopenia (all P<0.05), and skeletal muscle mass, BMI and annual income were the influencing factors of mental status of MHD patients with sarcopenia (P<0.05, P<0.01). Conclusion The incidence of sarcopenia is high in MHD patients. Sarcopenia is related to poor quality of life, and anxiety and depressive symptoms, highlighting the importance of early detection and attention to sarcopenia. |
| Key words: maintenance hemodialysis sarcopenia quality of life mental status |
