摘要：

目的 调查血液透析患者不宁腿综合征发病率并筛查其相关危险因素。 方法 共220 例维持性血液透析患者和40 例慢性肾脏病患者，采用国际不宁腿综合征研究组评价量表（IRLS）评价不宁腿综合征严重程度，Beck 抑郁量表（BDI）评价抑郁症状，Epworth 嗜睡量表评价白天过度嗜睡，失眠严重程度指数（ISI）评价失眠程度。采用单因素和多因素前进法Logistic 回归分析筛查血液透析患者发生不宁腿综合征的相关危险因素。 结果 血液透析组病程（Z = - 9.837，P = 0.000）、血清铁蛋白（t = 2.847，P = 0.005）、合并不宁腿综合征比例（χ² = 10.918，P = 0.001）、应用镇静催眠药比例（χ² = 7.669，P = 0.006）、IRLS 评分（t = 2.322，P = 0.020）和ISI 评分（Z = 4.117，P = 0.001）均高于对照组。单因素和多因素前进法Logistic回归分析显示，糖尿病（OR = 3.387，95%CI ：1.538 ~ 7.461；P =  0.002）、BDI评分> 9 分（OR = 2.643，95%CI：1.457 ~ 4.795；P = 0.001）和ISI 评分> 7 分（OR = 3.542，95%CI ：1.939 ~ 6.468；P = 0.000）是血液透析患者发生不宁腿综合征的独立危险因素。 结论 血液透析患者不宁腿综合征和失眠发病率较高，不宁腿综合征与失眠密切相关，抑郁症状在其中发挥重要作用。

关键词: 血液透析滤过, 不宁腿综合征, 危险因素, 回归分析

Abstract:

Objective  To investigate the incidence of restless legs syndrome (RLS) in hemodialysis patients and to analyze the related risk factors.  Methods  There were 220 cases of hemodialysis as hemodialysis group and 40 cases of chronic nephrosis as control group. The severity of RLS was measured by International Restless Legs Syndrome Study Group Rating Scale (IRLS). Beck Depression Inventory (BDI) was used to evaluate the status of depression, Epworth Sleepiness Scale (ESS) was used to evaluate excessive daytime sleepiness (EDS), and Insomnia Severity Index (ISI) was used to evaluate the status of insomnia. Univariate and multivariate forward Logistic regression analysis was used to analyze the related risk factors for RLS in hemodialysis patients.  Results  In hemodialysis group duration (Z =-9.837, P = 0.000), serum ferritin (t = 2.847, P = 0.005), incidence rate of RLS (χ² = 10.918, P = 0.001), the proportion of using hypnotic drugs (χ² = 7.669, P = 0.006), IRLS (t = 2.322, P = 0.020) and ISI (Z = 4.117, P = 0.001) were significantly higher than control group. Univariate and multivariate forward Logistic regression analysis showed diabetes (OR = 3.387, 95% CI: 1.538-7.461; P = 0.002), BDI > 9 score (OR = 2.643, 95% CI: 1.457-4.795; P = 0.001) and ISI > 7 score (OR = 3.542, 95%CI: 1.939-6.468; P = 0.000) were independent risk factors for RLS in hemodialysis patients.  Conclusions  Hemodialysis patients have a high incidence of RLS and insomnia. RLS is closely related with insomnia. Depression plays an important role therein.

Key words: Hemodiafiltration, Restless legs syndrome, Risk factors, Regresssion analysis