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尿毒症血液透析患者胃肠道症状的发生情况及影响因素研究

Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia.

作者信息

Yuan Dan, Wang Xiao-Qi, Shao Feng, Zhou Jing-Jing, Li Zhong-Xin

机构信息

Department of Nephrology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101100, China.

出版信息

World J Gastrointest Surg. 2024 Jul 27;16(7):2157-2166. doi: 10.4240/wjgs.v16.i7.2157.

Abstract

BACKGROUND

Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis, and these symptoms seriously affect patients' prognosis.

AIM

To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.

METHODS

We retrospectively selected 98 patients with uremia who underwent regular hemodialysis treatment in the blood purification center of our hospital from December 2022 to December 2023. The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale (GSRS). Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms. The factors that may affect gastrointestinal symptoms were identified by single-factor analysis. Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.

RESULTS

Gastrointestinal symptoms included indigestion, constipation, reflux, diarrhea, abdominal pain, and eating disorders, and the total average GSRS score was 1.35 ± 0.47. This study showed that age, number of tablets, dialysis time, glucocorticoid, parathyroid hormone (PTH), combined diabetes mellitus and C-reactive protein (CRP) were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis, whereas body mass index (BMI), hemoglobin (Hb), and urea clearance index were independent protective factors ( < 0.05).

CONCLUSION

Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis, most commonly including dyspepsia, eating disorders, and gastroesophageal reflux. The independent influencing factors mainly include the BMI, age, number of pills taken, dialysis time, urea clearance index, Hb, use of glucocorticoids, and thyroid hormone level. PTH, CRP, and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms, and targeted prevention can be performed.

摘要

背景

胃肠道症状在接受血液透析的尿毒症患者中很常见,这些症状严重影响患者的预后。

目的

评估接受血液透析的尿毒症患者胃肠道症状的发生率及影响因素。

方法

回顾性选取2022年12月至2023年12月在我院血液净化中心接受规律血液透析治疗的98例尿毒症患者。采用胃肠道症状分级量表(GSRS)评估患者的胃肠道症状及各维度得分。根据是否有胃肠道症状将患者分为胃肠道症状组和无胃肠道症状组。通过单因素分析确定可能影响胃肠道症状的因素。进行多因素logistic回归分析以确定胃肠道症状的独立危险因素。

结果

胃肠道症状包括消化不良、便秘、反流、腹泻、腹痛及进食障碍,GSRS总平均分是1.35±0.47。本研究表明,年龄、服药片数、透析时间、糖皮质激素、甲状旁腺激素(PTH)、合并糖尿病及C反应蛋白(CRP)是接受血液透析的尿毒症患者胃肠道症状的独立危险因素,而体重指数(BMI)、血红蛋白(Hb)及尿素清除指数是独立保护因素(P<0.05)。

结论

接受血液透析的尿毒症患者胃肠道症状大多较轻,最常见的包括消化不良、进食障碍及胃食管反流。独立影响因素主要包括BMI、年龄、服药片数、透析时间、尿素清除指数、Hb、糖皮质激素使用情况及甲状旁腺激素水平。PTH、CRP及糖尿病是影响胃肠道症状发生的临床相关因素,可进行针对性预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de1d/11287689/739cac747193/WJGS-16-2157-g001.jpg

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