目的 调查维持性血液透析患者不宁腿综合征(RLS)的患病率及相关危险因素,评估RLS对透析患者生活质量、焦虑抑郁障碍的影响.方法 入选维持性血液透析患者11 5例,收集患者临床资料及相关实验室检查数据.根据RLS诊断标准,将患者分为RLS组和非RLS组,应用单因素及多元Logistic回归分析RLS危险因素.采用健康状况调查表(SF-36)、焦虑自评量表(SAS)和抑郁自评量表(SDS)了解RLS对血液透析患者生活质量及心理的影响.结果 115例维持性血液透析患者中RLS患病率20.87％;单因素分析发现,RLS患者透析时间(P＜0.05)、转铁蛋白(P＜0.05)、β2微球蛋白(P＜0.01)、同型半胱氨酸(P＜0.01)均高于非RLS患者;尿量(P＜0.05)低于非RLS患者,女性饮酒史与RLS相关(P＜0.05).两组患者在性别、年龄、身体质量指数家、原发疾病、高血压病史、糖尿病史、血红蛋白、血清铁、转铁蛋白饱和度、肌酐、尿素氮、甲状旁腺素、电解质等无明显差异.Logistic回归分析示,高β2微球蛋白(OR 1.48,95％CI 1.054-2.077)、高维生素B12 (OR 1.006,95％CI 1.001-1.012)、高同型半胱氨酸(OR 1.595,95％CI 1.029-2.474)为RLS发生的危险因素.RLS患者SAS、SDS、心理健康评分均高于非RLS患者(P＜0.05).结论 维持性血液透析患者RLS患病率较高,β2微球蛋白、维生素B12、同型半胱氨酸升高为RLS的主要危险因素;RLS可明显升高血液透析患者SAS、SDS评分和降低心理健康评分,抑郁症状与RLS严重程度相关.%Objective To investigate the prevalence and risk factors of restless legs syndrome (RLS) in maintenance hemodialysis (MHD) patients,and evaluate the effect of RLS on quality of life and anxiety and depression in dialysis patients.Methods A total of 115 patients with MHD were enrolled in this study.General data,clinical data and related laboratory data were collected.Patients were divided into RLS positive group and RLS negative group according to RLS diagnostic criteria,and the risk factors of RLS was analyzed using univariate and multivariate logistic regression analyses.The questionnaire (SF-36),Self-Rating Rating Scale (SAS) and Self-Rating Depression Scale (SDS) were used to assess the effect of RLS on quality of life and psychological status of hemodialysis patients.Results The prevalence of RLS in 115 patients with MHD was 20.87％.The univariate analysis revealed that patients with RLS had longer duration of dialysis therapy (P＜0.05),higher levels of transferrin (P＜0.05),β2 microglobulin (P＜0.01) and homocysteine (P＜0.01),and lower levels of urine volume than those without RLS.The history of female drinking was related to RLS (P＜ 0.05).No significant difference was found in gender,age,body mass index,primary disease,history of hypertension,history of diabetes,hemoglobin,serum iron,transferrin saturation,creatinine,blood urea nitrogen,PTH,electrolyte between patients with and without RLS.Logistic regression analysis showed that high β2 microglobulin (OR 1.48 95 ％ CI 1.054-2.077,high vitamin B12 (OR 1.006 95％ CI 1.001-1.012),and homocysteine (OR 1.595 95％ CI 1.029-2.474) were risk factors for RLS.The SAS,SDS and mental health scores in patients with RLS were significantly higher than in those without RLS (P＜0.05).Conclusions The prevalence of RLS in MHD patients was higher,and elevated β2-microglobulin,vitamin B12 and homocysteine were the main risk factors for RLS.RLS significantly increased SAS,SDS scores and reduced mental health scores in hemodialysis patients,which may be related to the severity of RLS.
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