Sørensen V R, Mathiesen E R, Watt T, Bjorner J B, Andersen M V N, Feldt-Rasmussen B
Department of Nephrology, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Diabetologia. 2007 Nov;50(11):2254-62. doi: 10.1007/s00125-007-0810-1. Epub 2007 Sep 18.
AIMS/HYPOTHESIS: The aim of this study was to describe the prevalence of complications, health-related quality of life (HRQOL) and the influence of beliefs about control over health in diabetic dialysis patients.
Of 53 eligible diabetic patients on chronic dialysis during January 2004 in our clinic, 38 (76%) completed a kidney-specific (Kidney Disease Quality of Life) and a generic (SF-36) questionnaire and were characterised in terms of cardiovascular diseases and diabetic complications. Matched groups of non-diabetic dialysis patients (n = 40) and diabetic patients with a long duration of diabetes and normal kidney function (n = 38) served as controls. Generic HRQOL was compared with matched data from a survey on the Danish general population (n = 2248).
Micro- and macrovascular complications were significantly more frequent in diabetic dialysis patients than in diabetic patients without renal disease. Self-rated physical health was significantly worse (p < 0.01) in diabetic dialysis patients (35 +/- 9 [mean +/- SD]) compared with non-diabetic dialysis patients (41 +/- 10), diabetic patients with normal kidney function (45 +/- 12) and the matched general population (47 +/- 19). The diabetic dialysis patients had similar levels of kidney-specific quality of life and mental health compared with the control groups. Reduced physical health was predicted by the presence of end-stage renal disease, diabetes and short time spent in education. Among the diabetic patients, those who believed more on their own ability to control their diabetes and less on chance reported better mental health and were less likely to be on dialysis.
CONCLUSIONS/INTERPRETATIONS: Diabetic dialysis patients are characterised by a high prevalence of diabetic complications, reduced self-rated physical health but relatively good mental health.
目的/假设：本研究旨在描述糖尿病透析患者并发症的患病率、健康相关生活质量（HRQOL）以及对健康控制信念的影响。
2004年1月在我们诊所接受慢性透析的53例符合条件的糖尿病患者中，38例（76%）完成了肾脏特异性（肾脏病生活质量）和通用（SF - 36）问卷，并根据心血管疾病和糖尿病并发症进行了特征描述。匹配的非糖尿病透析患者组（n = 40）和糖尿病病程长且肾功能正常的糖尿病患者组（n = 38）作为对照组。将通用的HRQOL与丹麦普通人群调查（n = 2248）的匹配数据进行比较。
糖尿病透析患者的微血管和大血管并发症明显比无肾脏疾病的糖尿病患者更频繁。糖尿病透析患者的自评身体健康状况明显更差（p < 0.01）（35 ± 9 [平均值 ± 标准差]），与非糖尿病透析患者（41 ± 10）、肾功能正常的糖尿病患者（45 ± 12）和匹配的普通人群（47 ± 19）相比。与对照组相比，糖尿病透析患者的肾脏特异性生活质量和心理健康水平相似。终末期肾病、糖尿病的存在以及接受教育时间短预示着身体健康状况下降。在糖尿病患者中，那些更相信自己控制糖尿病的能力而较少相信运气的患者心理健康状况更好，且进行透析的可能性较小。
结论/解读：糖尿病透析患者的特点是糖尿病并发症患病率高、自评身体健康状况下降，但心理健康状况相对较好。
