维持性血液透析患者尿毒症皮肤瘙痒的相关因素

Analysis of related factors of uremia pruritus in maintenance hemodialysis patients

摘要:

探讨维持性血液透析（MHD）患者尿毒症皮肤瘙痒（UP）的相关因素，分析影响UP发生的危险因素及其与焦虑、抑郁及睡眠之间的相关性。方法 纳入南充市中心医院血液透析中心2021年4月～2021年9月的MHD患者227例为研究对象，收集患者的一般资料及实验室指标。使用量表［5-D瘙痒量表（5D-IS）、医院用焦虑抑郁量表（HADS）、阿森斯失眠量表（AIS））］进行评估，并将患者分为瘙痒组与无瘙痒组，瘙痒组又分为轻度瘙痒组、中度瘙痒组、重度瘙痒组；根据年龄将＞65岁患者设为老年组，＜65岁患者设为非老年组。使用 SPSS 25.0 统计软件进行统计分析。结果 227例MHD患者中患UP 153例（患病率67.4%）；瘙痒组患者在年龄、C反应蛋白（CRP）、血清肌酐（SCr）、血清胱抑素-C（Cys-C）及甘油三酯（TG）较无瘙痒组患者更高（P＜0.05）；而在不同瘙痒程度的UP患者间，年龄、CRP及血清无机磷（IP）差异有统计学意义（P＜0.05），年龄及CRP在重度瘙痒组高于轻度瘙痒组，中度瘙痒组血清无机磷（IP）高于重度瘙痒组（P＜0.05）。二元Logistic回归分析结果显示，高龄、高SCr、高Cys-C及高TG水平是MHD患者发生UP的独立危险因素。相关性分析中，MHD患者5D-IS评分与HADS焦虑评分之间成极弱正相关（P=0.04），与AIS〖JP2〗评分成弱正相关（P＜0.01）。结论 MHD患者UP的患病率较高；年龄、CRP、SCr、Cys-C及TG水平与UP的发生相关；〖JP〗高龄、高SCr、高Cys-C及高TG水平是导致UP发生的独立危险因素。MHD患者UP与焦虑、睡眠存在一定相关性

关键词:尿毒症皮肤瘙痒;血液透析;影响因素;焦虑抑郁;睡眠

Abstract:

To investigate the prevalence of Uremic Pruritus (UP) in patients with Maintenance Hemodialysis (MHD) in Nanchong Central Hospital, analyze the related factors of UP, and explore the risk factors influencing UP and the correlation with anxiety, depression and sleep.Methods A total of 227 MHD patients were enrolled in this cross-sectional study from April to September 2021 in the Hemodialysis Center of Nanchong Central Hospital. General clinical data and laboratory indicators were collected. Groups were assessed using scales (5-D Itch Scale (5D-IS), Hospital Use Anxiety and Depression Scale (HADS), and Parsons Insomnia Scale (AIS)).SPSS25.0 statistical software was used for statistical analysis.Results Among 227 MHD patients, 153 had UP (prevalence rate 67.4%). The age, C-reactive protein (CRP), serum creatinine (SCr), serum cystatin C (Cys-C) and triglyceride (TG) of patients inpruritus group were higher than those innon-pruritus group.And, there were differences in age, CRP and serum inorganic phosphorus (IP) between patients inpruritus groupwith different pruritus degree (P＜0.05).Binary Logistic regression analysis showed that old age, high SCr, high Cys-C and high TG were independent risk factors for UP in MHD patients. In the correlation analysis, there was a extremely weak positive correlation between 5D-IS score and HADS anxiety score in MHD patients, and a weak positive correlation between 5D-IS score and AIS score.Conclusion The prevalence of UP was higher in MHD patients. Age, CRP, SCr, Cys-C and TG levels were correlated with the occurrence of UP. Advanced age, high SCr, high Cys-c and high TG levels were independent risk factors for UP.UP was correlated with anxiety and sleep in MHD patients

Key words:Uremia skinitching; Hemodialysis; Influencing factors; Anxiety and depression; Sleep