维持性血液透析患者衰弱的影响因素分析

Analysis of Influence Factors for Frailty among the Maintenance Hemodialysis Patients

摘要: 目的：调查与分析维持性血液透析(Maintenance hemodialysis, MHD)患者衰弱的影响因素，为临床干预提供依据。方法：横断面研究，选取2023年3月在潍坊市益都中心医院进行规律血液透析治疗的患者212名，收集患者的一般资料，采用Fried表型进行衰弱评分，将患者分为衰弱组(≥3分)与非衰弱组(<3分)，PHQ-9抑郁量表进行抑郁评分，GAD-7焦虑量表进行焦虑评分。使用t/u检验或卡方检验进行组间差异性分析，使用spearman进行相关性分析，使用logistic回归分析探索衰弱的影响因素。结果：MHD患者衰弱的发生率为43.5%。组间比较显示，年龄、性别、共病数量、血红蛋白、血清白蛋白、抑郁、焦虑、活动水平、收入及文化水平差异有统计学意义(P均<0.05)；Spearman相关分析显示，抑郁(r = 0.53)、年龄(r = 0.36)、焦虑(r = 0.30)、共病数量(r = 0.21)、女性(r = 0.15)与衰弱成正相关(P均<0.05)；活动水平(r = −0.45)、血清白蛋白(ALB) (r = −0.32)、文化水平(r = −0.25)、收入水平(r = −0.16)、血红蛋白(Hb) (r = −0.16)与衰弱成负相关(P均<0.05)；Logistic回归分析显示，衰弱的影响因素包括年龄、性别、共病数量、血清白蛋白、焦虑、抑郁、活动水平、收入及文化水平(P均<0.05)。结论：MHD患者衰弱的发生率较高，年龄、性别、共病数量、血清白蛋白、焦虑、抑郁、活动水平、收入及文化水平可能是造成衰弱的影响因素。这为改善MHD患者衰弱及远期预后，提供了干预靶点。

Abstract: Objective: Investigate and analyze the influencing factors of debilitating maintenance hemodialysis (MHD) patients to provide a basis for clinical intervention. Methods: In a cross-sectional study, 212 patients who underwent regular hemodialysis treatment in Weifang Yidu Central Hospital in March 2023 were selected, the general information of the patients was collected, and the Fred phenotype was used for frailty score, and the patients were divided into frailty group (≥3 points) and non-frail group (<3 points); the PHQ-9 Depression Scale was for the depression score, and the GAD-7 Anxiety Scale was for the anxiety score. Use the t/u test or Chi-square test for intergroup difference analysis, Spearman for correlation analysis, and logistic regression analysis to explore the influencing factors of weakness. Results: The incidence of frailty in MHD patients was 43.5%. The comparison between groups showed that there were significant differences in age, sex, number of comorbidities, hemo-globin, serum albumin, depression, anxiety, activity level, income and education level (all P < 0.05), and Spearman correlation analysis showed that depression (r = 0.53), age (r = 0.36), anxiety (r = 0.30), number of comorbidities (r = 0.21), female (r = 0.15) were positively correlated with frailty (all P < 0.05); activity level (r = −0.45), serum albumin (ALB) (r = −0.32), education level (r = −0.25), income level (r = −0.16), hemoglobin (Hb) (r = −0.16) were negatively correlated with frailty (P < 0.05); logistic regression analysis showed that the influencing factors of frailty included age, sex, number of comorbidities, serum albumin, anxiety, depression, activity level, income and education level (all P < 0.05). Conclusion: The incidence of frailty in MHD patients is high, and age, sex, number of comorbidities, serum albumin, anxiety, depression, activity level, income and education level may be the influencing factors of frailty. This provides an intervention target for improving MHD patients’ frailty and long-term prognosis.