ISSN 2097-6054(网络) ISSN 1672-9234(印刷) CN 11-5289/R
主管:中国科学技术协会 主办:中华护理学会
出版:中华护理杂志社
收录:中国科学引文数据库(CSCD)来源期刊
   中国期刊全文数据库
   中国核心期刊(遴选)数据库
   Scopus
临床实践

维持性血液透析患者衰弱影响因素的Meta分析

  • 王丽娟 ,
  • 张淼 ,
  • 张鑫 ,
  • 李娟娟 ,
  • 肖雯怡 ,
  • 葛玉荣
展开
  • 750004 银川市 宁夏医科大学护理学院(王丽娟,张淼,李娟娟,肖雯怡);宁夏工商职业技术学院(张鑫);宁夏回族自治区人民医院医学教育管理处(葛玉荣)
王丽娟,女,本科(硕士在读),护师,E-mail:1335379094@qq.com

收稿日期: 2023-06-13

  网络出版日期: 2024-03-13

基金资助

宁夏自然科学基金(2023AAC03453)

Meta analysis of influencing factors of frailty in maintenance hemodialysis patients

  • Lijuan WANG ,
  • Miao ZHANG ,
  • Xin ZHANG ,
  • Juanjuan LI ,
  • Wenyi XIAO ,
  • Yurong GE
Expand

Received date: 2023-06-13

  Online published: 2024-03-13

摘要

目的 更新维持性血液透析患者衰弱影响因素的系统评价,为制订维持性血液透析患者衰弱早期识别和干预方案提供参考。 方法 检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science、CINAHL、Embase数据库,从建库至2023年11月22日有关维持性血液透析患者衰弱影响因素的所有文献及其参考文献,由2名研究者按照标准独立筛选文献、提取资料和评价文献质量。本研究采用Stata 15.0软件对衰弱影响因素进行Meta分析。 结果 共纳入23篇文献,样本量为8 644例。Meta分析结果显示,年龄、性别、糖尿病、周围血管疾病、心脏疾病、脑血管疾病、合并症、吸烟史、糖尿病肾病、跌倒史、抑郁、睡眠质量评分、营养评分、血红蛋白是衰弱的危险因素;血清白蛋白、日常活动能力评分、握力、体型标准是衰弱的保护因素(P<0.05)。体型偏瘦、运动锻炼、甲状旁腺激素和透析充分性与衰弱无关(P>0.05)。 结论 维持性血液透析患者衰弱影响因素较多,未来的研究可参考本研究结果,早期识别衰弱的高危人群,制订衰弱的干预方案,及早进行干预,改善患者的不良结局,提高患者的生存质量。

本文引用格式

王丽娟 , 张淼 , 张鑫 , 李娟娟 , 肖雯怡 , 葛玉荣 . 维持性血液透析患者衰弱影响因素的Meta分析[J]. 中华护理教育, 2024 , 21(3) : 365 -371 . DOI: 10.3761/j.issn.1672-9234.2024.03.018

Abstract

Objective To update the systematic review of the influencing factors of frailty in maintenance hemodialysis patients,and to provide references for early identification and intervention of frailty in maintenance hemodialysis patients. Methods Databases were searched incuding CNKI,Wanfang,VIP,SinoMed,PubMed,Cochrane Library,Web of Science,CINAHL,and Embase. The time limit was set from the date of database’s establishment to November 22,2023. All studies and references about the influencing factors of frailty in maintenance hemodialysis patients were searched. After that,two researchers independently screened,extracted and evaluated the literature according to the criteria. Stata 15.0 software was employed for analysis. Results A total of 23 literature were included,with a sample size of 8 644 cases. The results of meta-analysis showed that age,sex,diabetes,peripheral vascular disease,heart disease,cerebrovascular disease,comorbidities,smoking history,diabetic nephropathy,fall history,depression,sleep quality score,nutrition score and hemoglobin are risk factors for frailty;Serum albumin,daily activity score,grip strength and body size were protective factors for frailty(P<0.05). Meanwhile,underweight,exercise,parathyroid hormone and dialysis adequacy were not associated with frailty(P>0.05). Conclusion There are many factors influencing frailty in maintenance hemodialysis patients. Future studies can refer to the results of this study,identify the high-risk groups of faltering early,formulate faltering intervention programs,and intervene early to improve the clinical outcomes of patients,so as to improve the quality of life of patients.

参考文献

[1] 黄雨欣, 许丽春, 庄盼盼, 等. 维持性血液透析患者肌少症危险因素的Meta分析[J]. 护理学杂志, 2022, 37(13):17-21.
[2] Beddhu S, Chen XR, Wei G, et al. Associations of protein-ener-gy wasting syndrome criteria with body composition and mor-tality in the general and moderate chronic kidney disease populations in the United States[J]. Kidney Int Rep, 2017, 2(3):390-399.
[3] Clegg A, Young J, Iliffe S, et al. Frailty in elderly people[J]. Lancet, 2013, 381(9868):752-762.
[4] 吴淑琳, 宋洁, 肖萍, 等. 维持性血液透析患者衰弱发生率及影响因素的系统评价[J]. 中华护理教育, 2021, 18(4):352-357.
[4] Wu SL, Song J, Xiao P, et al. Systematic review of frailty pre-valence and its influencing factors in patients with main-tenance hemodialysis[J]. Chin J Nurs Educ, 2021, 18(4):352-357.
[5] Bloomfield K, Wu ZQ, Chan L, et al. Frailty prevalence in Aotearoa New Zealand haemodialysis patients and its association with hospitalisations[J]. N Z Med J, 2021, 134(1546):95-108.
[6] 杜兰玉, 胡霞, 王向弘, 等. 380例维持性血液透析患者衰弱现状及其对预后的影响[J]. 护理学报, 2018, 25(20):37-41.
[7] 吴淑琳. 维持性血液透析老年患者衰弱及短期不良结局事件的纵向研究[D]. 济南: 山东中医药大学, 2021.
[7] Wu SL. Longitudinal study on weakness and short-term adverse outcome events in elderly patients with maintenance hemodia-lysis[D]. Jinan: Shandong University of Traditional Chinese Me-dicine, 2021.
[8] 郭一丹, 张春霞, 田茹, 等. 老年维持性血液透析患者衰弱综合征的临床特征及其对全因死亡率的影响[J]. 中华肾脏病杂志, 2022, 38(7):589-596.
[8] Guo YD, Zhang CX, Tian R, et al. Clinical features of frailty syndrome and its association with all-cause mortality in elderly patients undergoing maintenance hemodialysis[J]. Chin J Nephrol, 2022, 38(7):589-596.
[9] Yuan HH, Zhang YJ, Xue GF, et al. Exploring psychosocial factors associated with frailty incidence among patients undergoing maintenance hemodialysis[J]. J Clin Nurs, 2020, 29(9/10):1695-1703.
[10] 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4):297-299.
[11] Stang A. Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010, 25(9):603-605.
[12] 朱亚杰, 陈思婕, 辛霞, 等. 维持性血液透析患者衰弱与肌少症及躯体功能的关系[J]. 护理学杂志, 2022, 37(9):42-45.
[12] Zhu YJ, Chen SJ, Xin X, et al. A study on frailty,sarcopenia,and physical functioning in maintenance hemodialysis patients[J]. J Nurs Sci, 2022, 37(9):42-45.
[13] 周雨婷, 蔡小霞, 林亚妹, 等. 老年维持性血液透析患者衰弱及其影响因素[J]. 中国老年学杂志, 2021, 41(8):1667-1670.
[13] Zhou YT, Cai XX, Lin YM, et al. Weakness of elderly main-tenance hemodialysis patients and its influencing factors[J]. Chin J Gerontol, 2021, 41(8):1667-1670.
[14] 陈凌云, 倪松, 施凌云, 等. 尿毒症患者维持性血液透析疲乏与衰弱发生率及其影响因素研究[J]. 中国中西医结合肾病杂志, 2021, 22(2):116-120.
[14] Chen LY, Ni S, Shi LY, et al. Study on the incidence and influencing factors of fatigue and weakness of maintenance hemodialysis in patients with uremia[J]. Chin J Integr Tradit West Nephrol, 2021, 22(2):116-120.
[15] 蔡康琴, 李伟, 王莉, 等. 血液透析患者衰弱现状的调查研究[J]. 护理学杂志, 2019, 34(11):24-27.
[16] 范炯同. 维持性血液透析患者衰弱现状及其影响因素的研究[D]. 承德: 承德医学院, 2021.
[16] Fan JT. Study on the current situation of weakness and its influencing factors in maintenance hemodialysis patients[D]. Chengde: Chengde Medical College, 2021.
[17] 解巧丽, 石瑞, 王德光. 老年维持性血液透析患者衰弱发生情况及其影响因素[J]. 中华老年多器官疾病杂志, 2023, 22(5):334-338.
[17] Xie QL, Shi R, Wang DG. Incidence of frailty in elderly patients undergoing maintenance hemodialysis and its influencing factors[J]. Chin J Mult Organ Dis Elder, 2023, 22(5):334-338.
[18] 朱亚杰, 陈思婕, 辛霞, 等. 老年维持性血液透析患者衰弱发生情况及影响因素分析[J]. 中华老年医学杂志, 2023, 42(1):35-39.
[18] Zhu YJ, Chen SJ, Xin X, et al. Analysis on the development and influencing factors of frailty in elderly patients on main-tenance hemodialysis[J]. Chin J Geriatr, 2023, 42(1):35-39.
[19] 赵文一. 维持性血液透析患者发生衰弱相关因素分析与护理对策研究[J]. 当代护士, 2022, 29(11):37-40.
[20] Wei Y, Wan Y, Zhang YJ, et al. Frailty prevalence and asso-ciated factors in patients on maintenance hemodialysis[J]. Int J Clin Exp Med, 2021, 14(6):2002-2009.
[21] Wang J, Huang LJ, Xu MC, et al. Study on the clinical impli-cations of NLR and PLR for diagnosing frailty in mainte-nance hemodialysis patients and their correlations with patient prognosis[J]. J Healthc Eng, 2022, 2022:1-7.
[22] Guo FL, Xu JL, Kang YQ, et al. Logistic regression analysis of frailty phenotype in the young and the middleaged main-tenance hemodialysis patients[J]. Acta Medica Mediterranea, 2021, 37(6):3577-3582.
[23] Takeuchi H, Uchida HA, Kakio Y, et al. The prevalence of frailty and its associated factors in Japanese hemodialysis patients[J]. Aging Dis, 2018, 9(2):192-207.
[24] Johansen KL, Chertow GM, Jin CS, et al. Significance of frailty among dialysis patients[J]. J Am Soc Nephrol, 2007, 18(11):2960-2967.
[25] 王云, 朱凌波, 刘君君, 等. 维持性血液透析患者衰弱的发生情况及其影响因素分析[J]. 临床肾脏病杂志, 2021, 21(5):375-380.
[25] Wang Y, Zhu LB, Liu JJ, et al. Analysis of the incidence and influencing factors of frailty in maintenance hemodialysis patients[J]. J Clin Nephrol, 2021, 21(5):375-380.
[26] 叶丽钦, 周莹, 张海林, 等. 社会支持对维持性血液透析老年患者衰弱的影响[J]. 中华老年医学杂志, 2019, 38(1):72-75.
[26] Ye LQ, Zhou Y, Zhang HL, et al. Influence of social supports on frailty in elderly maintenance hemodialysis patients[J]. Chin J Geriatr, 2019, 38(1):72-75.
[27] Chen GJ, Zhang HL, Du XJ, et al. Comparison of the prevale-nce and associated factors of cognitive frailty between elderly and middle-young patients receiving maintenance hemodialysis[J]. Int Urol Nephrol, 2022, 54(10):2703-2711.
[28] Kutner NG, Zhang R, Huang YJ, et al. Risk factors for frailty in a large prevalent cohort of hemodialysis patients[J]. Am J Med Sci, 2014, 348(4):277-282.
[29] Yadla M, John JP, Mummadi M. A study of clinical assess-ment of frailty in patients on maintenance hemodialysis sup-ported by cashless government scheme[J]. Saudi J Kidney Dis Transpl, 2017, 28(1):15-22.
[30] 张金金, 靳蕊霞, 孙伟. 高通量血液透析对老年终末期肾脏病患者衰弱的影响[J]. 临床荟萃, 2021, 36(4):328-331.
[31] Yoneki K, Kitagawa J, Hoshi K, et al. Association between frailty and bone loss in patients undergoing maintenance hemodialysis[J]. J Bone Miner Metab, 2019, 37(1):81-89.
[32] Kakio Y, Uchida HA, Takeuchi H, et al. Diabetic nephropathy is associated with frailty in patients with chronic hemodia-lysis[J]. Geriatr Gerontol Int, 2018, 18(12):1597-1602.
[33] 吴粉毅, 李维辛, 陈菲, 等. 老年衰弱的生物标记物研究进展[J]. 实用老年医学, 2020, 34(8):844-847.
[34] 李兰, 温贤秀, 夏琪, 等. 维持性血液透析患者抑郁患病率的meta分析[J]. 右江医学, 2021, 49(8):566-571.
[35] 周晓洲, 宁伟超, 李贤. 老年维持性血液透析病人跌倒预测模型的构建[J]. 护理研究, 2023, 37(12):2114-2121.
[36] 陈潇婷, 卜小宁. 吸烟与老年人衰弱的研究进展[J]. 中华全科医师杂志, 2023, 22(9):983-986.
[37] 马晓, 孙岩, 马英桓, 等. 维持性血液透析患者血红蛋白达标情况及影响因素分析[J]. 临床军医杂志, 2020, 48(8):964-966, 969.
[38] Spatola L, Finazzi S, Calvetta A, et al. Subjective Global Asse-ssment-Dialysis Malnutrition Score and cardiovascular risk in hemodialysis patients:an observational cohort study[J]. J Nephrol, 2018, 31(5):757-765.
[39] Velu S, Rajagopalan A, Arunachalam J, et al. Subjective assess-ment of sleep quality and excessive daytime sleepiness in conventional hemodialysis population:a single-center experie-nce[J]. Int J Nephrol Renovasc Dis, 2022, 15:103-114.
文章导航

/