摘要
目的探讨维持性血液透析患者残余肾功能(residual renal function,RRF)变化对症状困扰的影响。方法纳入复旦大学附属华山医院行维持性血液透析患者152例,根据24h尿量进行分组:RRF组(24h尿量≥200 ml)及无RRF组(24h尿量<200ml)。收集透析相关数据,应用"透析症状指数量表"评估症状困扰,用多因素线性回归及Logistic回归分析RRF与症状困扰的关系。结果①症状困扰发生率前5名:难以熟睡、性欲降低、感觉疲惫和缺乏活力、皮肤干燥、瘙痒。症状困扰严重程度前5名:骨骼关节疼痛、难以入睡、焦虑、悲伤、便秘。②多因素线性回归发现,残余肾功能与症状困扰严重程度总分呈负相关(t=-2.670;P=0.009)。且RRF组患者的呕吐、腹泻、不宁腿、足部麻木刺痛、感觉疲惫和缺乏活力、焦虑等症状困扰发生率低(OR值分别为0.071,0.064,0.053,0.123,0.187,0.132;Z值分别为-2.200,-2.130,-2.260,-2.540,-2.920,-2.410;P值分别为0.028,0.033,0.024,0.011,0.003,0.016)。结论有残余肾功能的血液透析患者症状困扰严重程度更低。
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