首页|尿毒症维持性血液透析患者衰弱风险的列线图模型建立及验证

尿毒症维持性血液透析患者衰弱风险的列线图模型建立及验证

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目的 探讨尿毒症维持性血液透析患者衰弱风险的影响因素并构建列线图预测模型.方法 选择2021 年5 月~2023 年9 月马鞍山市人民医院肾内科收治的 210 例尿毒症维持性血液透析患者作为研究对象,分为衰弱组(出现衰弱症状)54 例和非衰弱组(未出现衰弱症状)156 例,对两组患者的临床资料进行单因素分析,并将有统计学意义的因素进行回归分析,绘制列线图,确定尿毒症维持性血液透析患者衰弱风险的影响因素.结果 两组患者在性别、体质量指数(body mass index,BMI)、教育水平、吸烟史、糖尿病史、高血压史、经济情况、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)、尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、胱抑素C(cystatin C,CysC)、钾(potassi-um,K)、钙(calcium,Ca)、磷(phosphorus,P)、甲状旁腺激素(parathyroid hormone,PTH)、血β2 微球蛋白(beta-2 microglobulin,β2-MG)、铁蛋白(serum ferritin,SF)、叶酸(folic acid,FA)比较,差异无统计学意义(P>0.05).与非衰弱组比较,年龄、透析时间、运动情况、简易体能测量表(SPPB)、白蛋白(albumin,Alb)、血红蛋白(hemoglobin,Hb)等,差异有统计学意义(P<0.05).多因素回归分析显示年龄≥60 岁、长透析时间、从不/偶尔运动是尿毒症维持性血液透析患者发生衰弱的独立危险因素(P<0.05),简易体能测量表(short physical performance battery,SPPB)的高评分和白蛋白(albumin,Alb)高水平是尿毒症维持性血液透析患者发生衰弱的保护因素(P<0.05),构建的列线图具有良好预测价值.结论 年龄≥60 岁、长透析时间、从不/偶尔运动会增加尿毒症维持性血液透析患者出现衰弱风险.
Construction and validation of a nomogram model for predicting frailty risk in uremia patients undergoing maintenance hemodialysis
Objective To explore the influencing factors of frailty risk in uremia patients un-dergoing maintenance hemodialysis and to construct a predictive nomogram model.Methods A total of 210 patients who underwent maintenance hemodialysis in the Department of Nephrolo-gy of Ma'anshan People's Hospital from May 2021 to September 2023 were selected as the study subjects.They were divided into frailty group(with frailty symptoms,n=54)and non-frailty group(without frailty symptoms,n=156).Univariate analysis was performed on the clinical data of the two groups,and statistically significant factors were subjected to regression analysis.A nomogram was plotted to determine the influencing factors of frailty risk in uremia patients undergoing maintenance hemodialysis.Results There was no statistical difference be-tween the two groups in terms of gender,body mass index(BMI),education level,smoking history,history of diabetes,history of hypertension,economic status,hospital anxiety and de-pression scale(HADS),blood urea nitrogen(BUN),creatinine(Cr),cystatin C(CysC),po-tassium(K),calcium(Ca),phosphorus(P),parathyroid hormone(PTH),blood β2-MG(be-ta-2 microglobulin),serum ferritin(SF),and folic acid(FA)(P>0.05).The frailty group showed statistically significant differences compared with the non-frailty group in age,duration of dialysis,physical activity status,short physical performance battery(SPPB),albumin(Alb),and hemoglobin(Hb)(P<0.05).Multivariate regression analysis indicated that age≥60 years,prolonged dialysis duration,and never/occasionally exercising were independent risk factors for the occurrence of frailty in patients with end-stage renal disease undergoing ma-intenance hemodialysis(P<0.05).A high SPPB score and high levels of Alb were protective factors against the onset of frailty in these patients(P<0.05).A nomogram was constructed,which demonstrated good predictive value.Conclusion Age≥60 years,prolonged dialysis,and infrequent/no exercise increase the risk of frailty in uremia patients undergoing mainte-nance hemodialysis.

uremiamaintenance hemodialysisfrailty risknomogram

徐璐、卓银霞、唐晓飞、钱光荣

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马鞍山市人民医院 肾内科,安徽 马鞍山 243000

尿毒症 维持性血液透析 衰弱风险 列线图

安徽省卫生健康科研项目

AHWJ2022b111

2024

哈尔滨医科大学学报
哈尔滨医科大学

哈尔滨医科大学学报

CSTPCD
影响因子:1.117
ISSN:1000-1905
年,卷(期):2024.58(2)
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