中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2012年
1期
10-15
,共6页
颜佳毅%张敏芳%倪兆慧%蒋蓉%章海芬%严玉澄%张伟明%黄佳颖%方炜%牟姗%王琴%钱家麒
顏佳毅%張敏芳%倪兆慧%蔣蓉%章海芬%嚴玉澄%張偉明%黃佳穎%方煒%牟姍%王琴%錢傢麒
안가의%장민방%예조혜%장용%장해분%엄옥징%장위명%황가영%방위%모산%왕금%전가기
肾疾病,慢性%矿物质%骨疾病,代谢性
腎疾病,慢性%礦物質%骨疾病,代謝性
신질병,만성%광물질%골질병,대사성
Kidney disease,chronic%Mineral material%Bone disease,metabolic
目的 调查我院慢性肾脏病(CKD)中、晚期非透析和透析患者矿物质和骨代谢紊乱的知晓率、治疗率和控制率.方法 选取503例CKD 3期以上的非透析和透析患者,通过问卷的形式,结合实验室检查了解患者对矿物质和骨代谢紊乱的知晓率、治疗率和控制率.结果 CKD中、晚期患者矿物质和骨代谢紊乱知识知晓率以血液透析患者最高,腹膜透析患者其次,非透析患者最低,差异有统计学意义(P＜0.01).知识调查总得分显示,腹膜透析[11(9,12)]和血液透析[13(11,15)]患者显著高于非透析患者[6(5,8)](P＜0.01).相关知识的了解程度与年龄(r=-0.11,P＜0.05)呈负相关；与文化程度(r=0.226,P＜0.01)、肾脏病病程(r=0.597,P＜0.01)和透析龄(r=0.366,P＜0.01)呈正相关.医护人员宣教是CKD中、晚期患者获取知识的主要渠道,在非透析、腹膜透析和血液透析患者中分别占94.0％、79.5％和69.4％.腹膜透析(88.6％)和血液透析(96.9％)患者的矿物质和骨代谢紊乱治疗率均显著高于非透析患者(58.2％)(均P＜ 0.01).在控制率方面,以K/DOQI指南为标准,非透析患者血钙、血磷、钙磷乘积和甲状旁腺素(PTH)等的达标率明显优于透析患者；在各项指标的达标数量上也显著优于透析患者(均P＜ 0.01).以KDIGO指南为标准,非透析(46.7％)和腹膜透析(36.9％)患者的血磷达标率均显著高于血液透析患者(23.6％)(均P＜ 0.01).结论 CKD中、晚期非透析患者矿物质和骨代谢紊乱的知晓率和治疗率较低,控制率较高；而透析患者的知晓率和治疗率较高,但控制率较低.
目的 調查我院慢性腎髒病(CKD)中、晚期非透析和透析患者礦物質和骨代謝紊亂的知曉率、治療率和控製率.方法 選取503例CKD 3期以上的非透析和透析患者,通過問捲的形式,結閤實驗室檢查瞭解患者對礦物質和骨代謝紊亂的知曉率、治療率和控製率.結果 CKD中、晚期患者礦物質和骨代謝紊亂知識知曉率以血液透析患者最高,腹膜透析患者其次,非透析患者最低,差異有統計學意義(P＜0.01).知識調查總得分顯示,腹膜透析[11(9,12)]和血液透析[13(11,15)]患者顯著高于非透析患者[6(5,8)](P＜0.01).相關知識的瞭解程度與年齡(r=-0.11,P＜0.05)呈負相關；與文化程度(r=0.226,P＜0.01)、腎髒病病程(r=0.597,P＜0.01)和透析齡(r=0.366,P＜0.01)呈正相關.醫護人員宣教是CKD中、晚期患者穫取知識的主要渠道,在非透析、腹膜透析和血液透析患者中分彆佔94.0％、79.5％和69.4％.腹膜透析(88.6％)和血液透析(96.9％)患者的礦物質和骨代謝紊亂治療率均顯著高于非透析患者(58.2％)(均P＜ 0.01).在控製率方麵,以K/DOQI指南為標準,非透析患者血鈣、血燐、鈣燐乘積和甲狀徬腺素(PTH)等的達標率明顯優于透析患者；在各項指標的達標數量上也顯著優于透析患者(均P＜ 0.01).以KDIGO指南為標準,非透析(46.7％)和腹膜透析(36.9％)患者的血燐達標率均顯著高于血液透析患者(23.6％)(均P＜ 0.01).結論 CKD中、晚期非透析患者礦物質和骨代謝紊亂的知曉率和治療率較低,控製率較高；而透析患者的知曉率和治療率較高,但控製率較低.
목적 조사아원만성신장병(CKD)중、만기비투석화투석환자광물질화골대사문란적지효솔、치료솔화공제솔.방법 선취503례CKD 3기이상적비투석화투석환자,통과문권적형식,결합실험실검사료해환자대광물질화골대사문란적지효솔、치료솔화공제솔.결과 CKD중、만기환자광물질화골대사문란지식지효솔이혈액투석환자최고,복막투석환자기차,비투석환자최저,차이유통계학의의(P＜0.01).지식조사총득분현시,복막투석[11(9,12)]화혈액투석[13(11,15)]환자현저고우비투석환자[6(5,8)](P＜0.01).상관지식적료해정도여년령(r=-0.11,P＜0.05)정부상관；여문화정도(r=0.226,P＜0.01)、신장병병정(r=0.597,P＜0.01)화투석령(r=0.366,P＜0.01)정정상관.의호인원선교시CKD중、만기환자획취지식적주요거도,재비투석、복막투석화혈액투석환자중분별점94.0％、79.5％화69.4％.복막투석(88.6％)화혈액투석(96.9％)환자적광물질화골대사문란치료솔균현저고우비투석환자(58.2％)(균P＜ 0.01).재공제솔방면,이K/DOQI지남위표준,비투석환자혈개、혈린、개린승적화갑상방선소(PTH)등적체표솔명현우우투석환자；재각항지표적체표수량상야현저우우투석환자(균P＜ 0.01).이KDIGO지남위표준,비투석(46.7％)화복막투석(36.9％)환자적혈린체표솔균현저고우혈액투석환자(23.6％)(균P＜ 0.01).결론 CKD중、만기비투석환자광물질화골대사문란적지효솔화치료솔교저,공제솔교고；이투석환자적지효솔화치료솔교고,단공제솔교저.
Objective To investigate the awareness rate,treatment rate and control rate of mineral and bone disorder in patients with moderate or advanced stage chronic kidney disease (CKD). Methods The awareness rate,treatment rate and control rate of mineral and bone disorder were evaluated based on a questionnaire and related laboratory examinations in 503 CKD stage 3 to 5 patients. Results The awareness rate of mineral and bone disorder in patients with moderate or advanced stage CKD was highest in hemodialysis patients,moderate in peritoneal dialysis patients and lowest in non-dialyzed patients (all P ＜0.01).The total scores of the questionnaire were lowest in non-dialyzed patients [6 (5,8)] and were significantly higher in peritoneal dialysis [11 (9,12)] and hemodialysis patients [13 (11,15)] (P＜0.01).The extent of awareness was negatively correlated with age (r=-0.11,P＜0.05),and positively correlated with educational background (r=0.226,P＜0.01),duration of CKD (r=0.597,P＜0.01) and duration of dialysis (r=0.366,P＜0.01).The source of knowledge was mainly from publicity and education made by medical staff,which accounted for 94.0％,79.5％ and 69.4％ respectively in nondialyzed,peritoneal dialysis and hemodialysis patients.The treatment rate was significantly higher in peritoneal dialysis (88.6％) and hemodialysis patients (96.9％) than that in non-dialyzed patients (58.2％) (all P＜0.01).According to K/DOQI guideline,the control rate of serum calcium,phosphorus,calcium and phosphorus product and parathyroid hormone (PTH) were much better in non-dialyzed patients as compared to dialyzed ones.The percentage of number of lab indicators meeting the standard was significantly higher in non-dialyzed patients as compared to dialyzed ones (P＜0.01).According to KDIGO guideline,the control rate of serum phosphorus was significantly lower in hemodialysis patients (23.6％) than that in peritoneal dialysis (36.9％) and non-dialyzed patients (46.7％) (P＜0.01). Conclusions In non-dialyzed patients with moderate or advanced stage CKD,the awareness rate and treatment rate of mineral and bone disorder are relatively low,and the control rate is relatively high.Whereas in dialyzed patients,the awareness rate and treatment rate are relatively high,and the control rate is relatively low.
