- 期刊
血液透析病人骨質疏鬆之危險因子
Risk Factors for Osteoporosis among Hemodialysis Patients
摘要
目的：瞭解血液透析病人骨密度及探討影響病人骨密度相關因素，作為臨床照護參考。方法：採描述型研究設計，以二家區域醫院血液透析治療滿三個月以上末期腎臟病病人為樣本，共收案148人。收集資料有基本資料、醫師處置及檢驗值、骨密度。統計方法含平均值、標準差、層級複迴歸分析。結果：1.透析病人平均骨密度為-2.6，達骨質疏鬆標準佔52.7%；2.骨密度與年齡、總透析治療月數有相關，與BMI、副甲狀腺素等無顯著相關；3.複迴歸分析發現，年齡、性別、鈣、磷、鈣磷乘積及C肝為骨密重要預測因素，Adj-R2為23.1%。結論：除重視病人鈣磷平衡外，應適時轉介骨鬆治療；加強C型肝炎管控，預防病人跌倒避免骨折傷害。
並列摘要
Objectives: To estimate the bone density of hemodialysis patients and to analyze the related factors that affect bone density. Methods: We recorded a range of patient fundamental data using interviews. Next, using ultrasound bone densitometry, we measured the bone density of the patients, their body height and their body weight. The data associated with the patients' clinical treatment and blood chemistry were also collected. In total, 148 out of 180 hemodialysis patients from two regional hospitals in northern Taiwan participated in this investigation. Results: The mean bone density of the hemodialysis patients who took part in the investigation was 2.6, with 52.7% of them fulfilling the criteria indicating they were suffering form osteoporosis. Multiple regression analysis revealed that the important predicting factors in relation to bone density were age, sex, serum calcium level, serum phosphorus level, the calcium-phosphorus product and hepatitis C status, The Adj-r2 was 23.1%. Conclusions: This investigation suggests the medical staff should pay much more attention to the calcium and phosphate balance of hemodialysis patients. Furthermore, they should help patients who require bone care and transfer patients who need treatment for osteoporosis. In addition, it is important to control hepatitis C at hemodialysis centers and further investigations exploring the relationship between hepatitis C and bone density are required. Finally, it is critical to provide health education and assistance to hemodialysis patients who are at risk of falling.