老年慢性肾脏病患者身体活动及负性情绪对其生存质量的影响研究
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南京医科大学第一附属医院江苏省人民医院肾内科

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江苏省卫生健康委员会医学科研立项项目(Z2020220)


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DepartmentofNephrologyFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvincialPeoplesHospital

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    摘要:

    摘要:目的 探讨老年慢性肾脏病(CKD)患者身体活动及负性情绪对其生存质量的影响。方法 回顾性分析2022年1月至2023年12月在我院治疗的160例老年CKD患者一般临床资料。将GFR轻度受损的CKD1期~CKD2期患者纳入对照组(n=91),GFR中重度受损的CKD3期~CKD5期患者纳入观察组(n=69)。在入院后治疗前采用肾脏疾病生活质量简表(KDQOL-SFTM 1.3)评估患者生活质量,采用美国《国家健康与营养调查》评估患者运动能力,使用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)对患者焦虑状态、抑郁状态进行评估。应用SPSS 20.0统计软件处理文中数据,并根据数据类型,分别采用t检验或χ2检验进行组间比较,采用Pearson相关性分析老年CKD患者身体活动及负性情绪与生存质量相关性。结果 观察组KDTA评分 66.29±7.15分及SF-36评分总分52.35±6.19分明显低于对照组中的KDTA评分 80.61±9.36分及SF-36评分总分82.99±9.03分(t=10.974、25.442,P<0.05);观察组2MST、双手握力、30s座椅站立次数均显著低于对照组(t=1.550、20.339、14.128、23.546,P<0.05),观察组HAMA评分、HAMD评分明显高于对照组(t=34.996、24.915,P<0.05);相关性分析发现,老年CKD患者KDTA评分与患者身体活动中2MST、双手握力、30s座椅站立次数呈显著正相关(r=0.583、0.457、0.591,P<0.05),与HAMA评分、HAMD评分呈负相关(r=-0.616、-0.590,P<0.05);老年CKD患者SF-36评分与患者身体活动中2MST、双手握力、30s座椅站立次数与呈显著正相关(r=0.801、0.670、0.806,P<0.05),与HAMA评分、HAMD评分呈负相关(r=-0.824、-0.906,P<0.05)。结论 观察组患者生存质量评分和身体活动情况均明显低于对照组患者,并且观察组患者负性情绪评分则更高。此外,身体活动及负性情绪均分别与生存质量呈正相关、负相关,提示临床需加强对老年CKD患者身体活动及负性情绪的监测、干预,以改善老年CKD患者生存质量。

    Abstract:

    Abstract: Objective To investigate the effects of physical activity and negative emotion on quality of life in elderly patients with chronic kidney disease (CKD). Methods General clinical data of 160 elderly patients with CKD treated in our hospital from January 2022 to December 2023 were retrospectively analyzed. Patients with mildly impaired GFR stage CKD1 to CKD2 were included in the control group (n=91), and patients with moderately and severely impaired GFR stage CKD3 to CKD5 were included in the observation group (n=69). After admission and before treatment, KDQOL-SFTM 1.3 was used to assess the patients' quality of life; the exercise ability of the patients was assessed by the National Health and Nutrition Examination Survey of the United States; the anxiety and depression states of the patients were assessed by Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). SPSS 20.0 statistical software was used to process the data, and T-test or χ2 test were used to compare the data between groups according to the data type, respectively. Pearson correlation was used to analyze the correlation between physical activity and negative emotion and quality of life in elderly patients with CKD. Result KDTA score of 66.29±7.15 points and SF-36 score of 52.35±6.19 points in the observation group were significantly lower than that in the control group, KDTA score of 80.61±9.36 points and SF-36 score of 82.99±9.03 points (t=10.974、25.442,P < 0.05).2MST, two-hand grip strength and 30s chair standing times in the observation group were significantly lower than those in the control group (t=1.550, 20.339, 14.128, 23.546, P < 0.05), and HAMA and HAMD scores in the observation group were significantly higher than those in the control group (t=34.996, 24.915, P < 0.05). Correlation analysis found that elderly patients with chronic kidney disease (CKD) KDTA score and physical activity in patients with 2 MST, hands grip strength, 30 s seats stand number was significantly positive correlation (r = 0.583, 0.457, 0.591, P < 0.05), and negatively correlated with HAMA scores, HAMD score (r = 0.616, 0.590, P < 0.05); SF-36 scores in elderly CKD patients were significantly positively correlated with 2MST, two-handed grip strength and 30s chair standing times during physical activity (r=0.801, 0.670, 0.806, P < 0.05), and negatively correlated with HAMA and HAMD scores (r=-0.824, -0.906, P < 0.05). Conclusion The quality of life score and physical activity of patients in the observation group were significantly lower than those in the control group, and the negative emotion score of patients in the observation group was higher. In addition, physical activity and negative emotion were positively and negatively correlated with quality of life, respectively, suggesting that clinical monitoring and intervention of physical activity and negative emotion should be strengthened to improve the quality of life of elderly CKD patients.

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  • 收稿日期:2024-03-22
  • 最后修改日期:2024-05-16
  • 录用日期:2024-05-21
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