维持性血液透析患者限制饮食负担现状及影响因素分析-现代医学

维持性血液透析患者限制饮食负担现状及影响因素分析

单位：1. 亳州市人民医院血透中心, 安徽亳州 236800;
2. 阜阳市第二人民医院肾内风湿科, 安徽阜阳 236000

分类号：R459.5;R473.5

出版年·卷·期（页码）：2026·54·第六期（895-902）

摘要：

目的：探索维持性血液透析(MHD)患者限制饮食负担现状及影响因素，旨在为终末期肾病(ESRD)患者制定针对性干预措施提供依据。方法：采取便利抽样法选取2023年5月至2025年5月于我院接受MHD的ESRD患者作为研究对象，通过一般资料调查表、中文版慢性病患者限制饮食负担量表(BIRD)、中文版患者积极度量表(PAM)、特质情绪智力问卷简版(TEIQue-SF)和恐惧疾病进展简化量表(FoP-Q-SF)进行调查，采用Pearson相关分析评估BIRD评分与PAM评分、TEIQue-SF评分、FoP-Q-SF评分之间的相关性。采用多元线性回归分析MHD患者BIRD评分的影响因素。结果：MHD患者BIRD评分为(33.37±6.98)分，PAM评分为(26.40±7.36)分，TEIQue-SF评分为(86.84±14.30)分，FoP-Q-SF评分为(51.56±12.32)分。MHD患者BIRD评分在女性、年龄18～40岁、透析时间＞3年、初中及以下文化程度、无残余肾功能和无业状态的人群更高，差异有统计学意义(均P＜0.05)。Pearson相关分析发现，MHD患者BIRD评分与PAM评分(r=-0.705，P＜0.05)、TEIQue-SF评分(r=-0.570，P＜0.05)呈负相关，与FoP-Q-SF评分呈正相关(r=0.642，P＜0.05)。多元线性回归分析显示，女性、18～40岁/41～60岁、透析时间＞3年、初中及以下文化程度、无残余肾功能、无业、高FoP-Q-SF评分是MHD患者限制饮食负担的危险因素(β＞0，P＜0.05)，高PAM评分、高TEIQue-SF评分是MHD患者限制饮食负担的保护因素(β＜0，P＜0.05)。结论：MHD患者普遍存在较高水平的限制饮食负担，且女性、年龄小、透析时间长、文化水平低的人群限制饮食负担更大。临床应重点关注上述人群，通过系统性干预策略提升患者积极度与情绪调节能力，缓解其对疾病进展的恐惧，进而减轻MHD患者限制饮食负担，促进长期治疗依从性及生活质量的提升。

Objective: To explore the current status and influencing factors of dietary restriction burden in maintenance hemodialysis(MHD) patients, and to provide evidence for developing targeted interventions for patients with end-stage renal disease(ESRD).Methods: Using convenience sampling, ESRD patients who received MHD in our hospital from May 2023 to May 2025 were recruited. They were surveyed with a general information questionnaire, the Chinese version of the Burden of Dietary Restrictions for Patients with Chronic Disease(BIRD) scale, the Patient Activation Measure(PAM), the Trait Emotional Intelligence Questionnaire-Short Form(TEIQue-SF), and the Fear of Progression Questionnaire-Short Form(FoP-Q-SF). Pearson correlation analysis was performed to evaluate the relationships between the BIRD score and the PAM, TEIQue-SF, and FoP-Q-SF scores. Multiple linear regression analysis was used to identify influencing factors of the BIRD score in MHD patients. Results: The mean scores among MHD patients were 33.37±6.98 for BIRD, 26.40±7.36 for PAM, 86.84±14.30 for TEIQue-SF, and 51.56±12.32 for FoP-Q-SF. BIRD scores were significantly higher among females, patients aged 18-40 years, those with a dialysis duration >3 years, those with an education level of junior high school or below, those without residual renal function, and those who were unemployed(all P＜0.05). Pearson analysis showed that the BIRD score was negatively correlated with the PAM score(r=-0.705, P<0.05) and the TEIQue-SF score(r=-0.570, P<0.05), and positively correlated with the FoP-Q-SF score(r=0.642, P<0.05). Multiple linear regression analysis revealed that female sex, age 18-40/41-60 years, dialysis duration >3 years, education of junior high school or below, absence of residual renal function, unemployment, and a high FoP-Q-SF score were risk factors for dietary restriction burden(β>0, P＜0.05), whereas high PAM and high TEIQue-SF scores were protective factors(β<0, P<0.05).Conclusion:A high level of dietary restriction burden is prevalent among MHD patients, and the burden is greater among females, younger patients, those with longer dialysis durations, and those with lower educational levels. Clinical attention should focus on these subgroups, and systematic intervention strategies should be implemented to enhance patient activation and emotional regulation, alleviate fear of disease progression, and thereby reduce dietary restriction burden and promote long-term treatment adherence and quality of life.

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