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腹膜透析患者低肌肉组织指数相关影响因素分析

Risk factors of low lean tissue index in peritoneal dialysis patients

    摘要
  • 摘要:
    目的 探讨规律腹膜透析（腹透）患者低肌肉组织指数（lean tissue index，LTI）的发生率及相关影响因素。
    方法 选择2019年10月至2020年5月在上海健康医学院附属嘉定区中心医院接受规律腹透治疗的患者。应用多频生物电阻抗技术测量入选患者的LTI，采集人口统计学资料、生化指标，评估患者的腹膜转运特性及透析充分性。根据LTI是否小于同性别、年龄健康人群参考范围的第10百分位数，将入组患者分为低LTI组和LTI正常组。分析腹透患者低LTI的发生率。用多因素logistic回归法分析腹透患者低LTI的影响因素。
    结果 共入选104例患者，其中低LTI组49例，低LTI的发生率为47.1%。与LTI正常组患者相比，低LTI组患者红细胞分布宽度（RDW）、白细胞介素6（IL-6）浓度、主观全面评估（SGA）评分等级、容量负荷均升高（P < 0.05），体质量指数（BMI）降低（P < 0.05）。多因素logistic回归分析结果显示，IL-6（OR=1.098，95% CI 1.024~1.177，P=0.009）、RDW（OR=1.873，95% CI 1.183~2.965，P=0.007）、BMI（OR=0.787，95% CI 0.679~0.911，P=0.001）和SGA评分等级（OR=6.334，95% CI 1.568~25.295，P=0.009）是低LTI发生的独立相关因素。
    结论 腹透患者低LTI发生率高，较高的IL-6、RDW、SGA评分等级和较低的BMI是腹透患者低LTI发生的独立危险因素。

     

    Abstract:
    Objective To investigate the incidence of low lean tissue index (LTI) and analyze the risk factors of low LTI in peritoneal dialysis (PD) patients.
    Methods PD patients in Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences from October 2019 to May 2020 were included. Demographic data of patients were collected and biochemical parameters were measured. LTI was measured by bioimpedance spectroscopy. Patients with an LTI less than 10% of the referenced range for their age and gender were considered to have a low LTI. Multivariate logistic regression was used to analyze the risk factors of low LTI.
    Results A total of 104 PD patients were included, and low LTI was detected in 49 patients (47.1%). Compared to the normal LTI group, the red cell distribution width (RDW), interleukin-6 (IL-6) concentration, subjective global assessment(SGA) grade, and overhydration in the low LTI group were increased (P < 0.05), whereas body mass index (BMI) was decreased (P < 0.05). Multivariate logistic regression showed that IL-6 concentration (OR=1.098, 95%CI 1.024-1.177, P=0.009), RDW (OR=1.873, 95%CI 1.183-2.965, P=0.007), BMI (OR=0.787, 95%CI 0.679-0.911, P=0.001), and the SGA grade (OR=6.334, 95%CI 1.568-25.295, P=0.009) were independent risk factors of LTI.
    Conclusions Low LTI is common in PD patients, higher IL-6, RDW, SGA grade, and lower BMI are independent risk factors of low LTI.

     

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