背景:胃肠道症状在尿毒症患者血液透析中很常见,这些症状严重影响患者的预后。
目的:评估尿毒症血液透析患者消化道症状的发生情况及其影响因素。
方法:回顾性选择2022年12月至2023年12月在我院血液净化中心接受常规血液透析治疗的尿毒症患者98例。采用胃肠道症状评分量表(GSRS)对胃肠道症状及各维度评分进行评价。根据患者是否有胃肠道症状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。采用多因素logistic回归分析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,和饮食失调,GSRS总平均得分为1.35±0.47。这项研究表明,年龄,片剂的数量,透析时间,糖皮质激素,甲状旁腺激素(PTH),合并糖尿病和C反应蛋白(CRP)是尿毒症血液透析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),尿素清除指数为独立保护因素(P<0.05)。
结论:尿毒症血液透析患者的胃肠道症状大多轻微,最常见的包括消化不良,饮食失调,胃食管反流.独立影响因素主要包括BMI,年龄,服用的药片数量,透析时间,尿素清除指数,Hb,使用糖皮质激素,甲状腺激素水平.PTH,CRP,和糖尿病是影响胃肠道症状发生的临床相关因素,可以进行有针对性的预防。
BACKGROUND: Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis, and these symptoms seriously affect patients\' prognosis.
OBJECTIVE: 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 (P < 0.05).
CONCLUSIONS: 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.