Ice Pica: A Neglected Behavior among Hemodialysis Patients in Taiwan

嗜冰癖：一種血液透析病患常被忽略的行為

邱文淵(Wen-Yuan Chiu) ； 張浤榮(Horng-Rong Chang) ； 林文鶯(Enny Halim) ； 連榮達(Jong-Da Lian)

《Acta Nephrologica》 20卷1期 (2006/01) Pp. 17-21

摘要

嗜異癖是一種對食物或非食物的強烈渴望。嗜冰癖是嗜異癖中最常見的一種。但台灣有關於這種行為的研究十分少見。本文試著探討血液透析病患嗜冰癖的致病因素，其對身體生化代謝的影響及其併發症。從2004年1月至2004年12月我們訪談調查了七十六位血液透析病患。其中一位作者和一位營養師在二十四小時的飲食記錄單和嗜冰癖問卷訪談當中發現十四位(18.4%)血液透析病患有嗜冰癖的行為。嗜冰癖病人群中病患年齡較輕；女性病患較多；較常見患有糖尿病；且病患血液透析時間較久，但不具有統計意義。嗜冰癖病患和無嗜冰癖病患之間每月的常規檢查、透析劑量並無差別。嗜冰癖病人群中病患血色素濃度較高；透析間體重增加較多；BMI較高，且具統計意義。兩組病患的血清鐵；鋅；銅濃度並無差別。探究嗜冰的原因為(1)解渴，(2)緩和口乾及嘴苦的感覺，(3)有強烈想咬硬東西的慾望，(4)抑制想吃東西的慾望。我們對於嗜冰癖這一種血液透析病患常被忽略的行為必須有所認識，因為這種行為會增加水分控制的困難，增加透析間體重過重的危險性。

關鍵字

嗜冰癖 ； 血液透析

並列摘要

Pica is a compulsive behavior of eating food or non-food items. Ice pica has recently been linked with the ESRD population. However, there is little information on this behavior in Taiwan. From Jan 2004 to Dec 2004, we studied the occurrence, possible etiological factors, metabolic disturbances and potential complications of ice pica among 76 patients maintained on hemodialysis. According to a one-day diet record and specific questionnaire about ice pica, 18.4% (14/76) of patients had this behavior. The hemoglobin levels, interdialytic weight gains (IDWGs) and BMI were significantly higher in patients with ice pica than those without. Ice pica tended to be associated with younger age and longer hemodialysis treatment duration but without statistical significance (p=0.086 and 0.067). There was no significant difference between patients with or without ice pica in all the monthly laboratory measures including iron, zinc and copper levels and clinical outcomes. The reasons for ice pica among our patients were most for ”relieving thirst”, followed by ”relieving bitter and dry sensation of mouth”, ”strong desire for munching hard stuff” and ”ease eating desires”. In summary, ice pica is a neglected behavior in hemodialysis patients in Taiwan. We should keep this problem in mind because covert ice pica may hinder the success of prescribed fluid restriction and increase risks of interdialytic weight gains.

並列關鍵字

ice pica ； hemodialysis