血液透析患者的腰痛：危险因素及其对健康相关生活质量的影响。
Low back pain in hemodialysis patients: Risk factors and its impact on health-related quality of life.
作者信息
Kesikburun Bilge, Ekşioğlu Emel, Akdağ İbrahim, Çakçı Aytül
机构信息
Department of Physical Medicine and Rehabilitation, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Department of Nephrology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
出版信息
Turk J Phys Med Rehabil. 2017 Nov 15;64(1):66-71. doi: 10.5606/tftrd.2018.1016. eCollection 2018 Mar.
OBJECTIVES
The aim of this study was to evaluate frequency and characteristics of low back pain and to identify possible risk factors of low back pain and its impact on health-related quality of life in hemodialysis patients.
PATIENTS AND METHODS
A total of 87 hemodialysis patients (41 males, 46 females; mean age: 53.3±15.8 years; range, 21 to 80 years) were included in the study between January 2015 and July 2015. Medical charts and face-to-face interviews were used to collect clinical and demographic data. A comprehensive clinical evaluation of low back pain was implemented. The patients were divided into two groups: those with (n=32) and without (n=55) low back pain. Demographic data, quality of life, pain, and disability were compared between the groups. Pain severity was assessed using the Visual Analog Scale (VAS). Low back pain-associated disability was measured using the Oswestry Disability Index (ODI). Risk factors of low back pain were identified using multiple logistic regression analysis. The impact of low back pain on health-related quality of life was measured using the Nottingham Health Profile (NHP).
RESULTS
Advanced age, increased body mass index, and smoking were found to be significant independent risk factors of low back pain (p=0.048; p=0.037; p=0.020, respectively). Energy, pain, and physical mobility subscale scores of the NHP were also higher in the hemodialysis patients with low back pain (p=0.008; p<0.001; p<0.001, respectively). Energy, pain, sleep, and physical mobility subscale scores of the NHP showed a significant positive correlation with the ODI scores (r=0.424, p=0.016; r=0.803, p<0.001; r=0.493, p=0.004; r=0.862, p<0.001, respectively). The etiology of low back pain was non-specific in the majority of the patients (71.9%). There were spondylodiscitis in two patients (6.2%), compression fractures in two patients (6.2%), spinal stenosis in one patient (3.1%), and discopathy in four patients (12.5%).
CONCLUSION
Low back pain is a common condition in hemodialysis patients. Advanced age, increased body mass index, and smoking are the main risk factors of low back pain. The presence of low back pain is also related to poor health-related quality of life in hemodialysis patients.
目的
本研究旨在评估血液透析患者中腰痛的发生率及特征，确定腰痛可能的危险因素及其对健康相关生活质量的影响。
患者与方法
2015年1月至2015年7月期间，共纳入87例血液透析患者（41例男性，46例女性；平均年龄：53.3±15.8岁；范围21至80岁）。通过病历和面对面访谈收集临床和人口统计学数据。对腰痛进行全面的临床评估。患者分为两组：有腰痛组（n = 32）和无腰痛组（n = 55）。比较两组之间的人口统计学数据、生活质量、疼痛和残疾情况。使用视觉模拟量表（VAS）评估疼痛严重程度。使用Oswestry残疾指数（ODI）测量与腰痛相关的残疾程度。通过多元逻辑回归分析确定腰痛的危险因素。使用诺丁汉健康量表（NHP）测量腰痛对健康相关生活质量的影响。
结果
高龄、体重指数增加和吸烟被发现是腰痛的显著独立危险因素（分别为p = 0.048；p = 0.037；p = 0.020）。有腰痛的血液透析患者的NHP能量、疼痛和身体活动分量表得分也更高（分别为p = 0.008；p < 0.001；p < 0.001）。NHP的能量、疼痛、睡眠和身体活动分量表得分与ODI得分呈显著正相关（分别为r = 0.424，p = 0.016；r = 0.803，p < 0.001；r = 0.493，p = 0.004；r = 0.862，p < 0.001）。大多数患者（71.9%）腰痛的病因是非特异性的。两名患者（6.2%）患有脊椎椎间盘炎，两名患者（6.2%）患有压缩性骨折，一名患者（3.1%）患有椎管狭窄，四名患者（12.5%）患有椎间盘病。
结论
腰痛在血液透析患者中是一种常见情况。高龄、体重指数增加和吸烟是腰痛的主要危险因素。腰痛的存在也与血液透析患者健康相关生活质量较差有关。
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