nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2005-9-3-48-54nefr-680Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSКАЧЕСТВО ЖИЗНИ БОЛЬНЫХ НА ХРОНИЧЕСКОМ ГЕМОДИАЛИЗЕQUALITY OF LIFE IN CHRONIC HEMODIALYSIS PATIENTSВасильеваИ. А.VasilievaI. A.Научно-исследовательский институт нефрологии, Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation200510032005934854Copyright © Васильева И.А., 20052005Васильева И.А.Vasilieva I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/680

ЦЕЛЬ ИССЛЕДОВАНИЯ. Сравнить показатели качества жизни (КЖ) больных, находящихся на лечении гемодиализом (ГД), и здоровых лиц, сопоставить показатели КЖ российских ГДпациентов и больных из других стран, определить факторы, влияющие на КЖ ГДпациентов. ПАЦИЕНТЫ И МЕТОДЫ. Обследовали 1047 больных, получавших лечение хроническим ГД. Для оценки связанного со здоровьем КЖ использована русскоязычная версия методики SF36 Health Status Survey. Определялись также показатели депрессии, астении, тревожности, особенностей личности, жизненных целей и ценностей, клиниколабораторные параметры с целью оценки их влияния на КЖ пациентов. РЕЗУЛЬТАТЫ. У больных, находящихся на лечении ГД, все показатели физического функционирования существенно ниже, чем у здоровых лиц. Это касается устойчивости к физическим нагрузкам (PF), ограничивающего влияния физического состояния на повседневную деятельность (RP), общего состояния здоровья (GH), интен сивности боли (BP). По показателям психического здоровья снижение по сравнению с нормой менее выраженное. У российских ГДбольных достоверно выше, чем у пациентов из США, показатели толерантности к физическим нагрузкам (PF) , общей активности (V) и суммарный индекс физического здоровья (PCS). Пациенты из США имеют преимущество по психическому здоровью (MH), суммарному показателю психического здоровья (MCS), свободе от боли (BP), общему состоянию здоровья (GH). Больных из Великобритании отличают более низкие, чем пациентов из России и США, оценки большинства шкал опросника SF 36, что связано, вероятно, с пониженным уровнем гемоглобина в этой группе больных. Уровень альбумина сыворотки крови является независимым предиктором сохранности суммарного показателя физического здоровья (PCS). Негативно влияют на суммарный показатель физического здоровья выраженность депрессии, возраст пациента, длительность ГД, количество дней госпитализации за последние 6 месяцев, наличие сопутствующей патологии. Суммарный показатель психического здоровья (MCS) зависит от уровней личностной тревожности, депрессии и астении, возраста и продолжительности лечения ГД. ЗАКЛЮЧЕНИЕ. КЖ больных, получающих хронический ГД, существенно снижено по сравнению со здоровыми лицами, главным образом за счет показателей физического здоровья. КЖ ГДпациентов подвержено влиянию клинических и психологических переменных. Требует дальнейшего изучения вопрос о том, что лежит в основе установленных различий по КЖ между ГД пациентами из разных стран – культуральные, социальноэкономические факторы или качество медицинской помощи.

THE AIM of the investigation was to compare quality of life (QL) indices of patients on hemodialysis (HD) and healthy subjects, to compare QL indices of Russian HD patients and those from other countries, to determine factors influencing QL of HD patients. PATIENTS AND METHODS. 1047 chronic hemodialysis patients were examined. To assess the healthrelated QL the Russian language version of the SF36 Health Status Survey was used. The indices of depression, asthenia, anxiety, personality features, life purposes and values, cliniclaboratory parameters were also determined for the assessment of their influence on patients’ QL. RESULTS. Patients on HD were found to have all indices of their physical functioning considerably lower than those in healthy subjects. It concerns the resistance to physical loads (PF), restricting effects of the physical state on the everyday activities (RP), general health condition (GH), intensity of pain (BP). According to the indices of mental health the decrease was less pronounced than normal. In Russian HD patients the tolerance indices to physical loads (PF), general activity (V) and the total index of physical health (PCS) were reliably higher than in US patients. The US patients possess an advantage in mental health (MH), total mental health index (MCS), freedom from pain (BP), general health condition (GH). Patients from Great Britain have lower rates of the majority of scales of the SF36 questionnaire than those from Russia and USA that seems to be associated with the lower level of hemoglobin in this group of patients. The blood serum albumin level is an independent predictor of safety of the total index of physical health (PCS). The degree of depression, patient’s age, duration of HD, number of days at the hospital for the last 6 months, and a coexisting pathology have negative influence on the total index of physical health (PCS). The total index of physical health (PCS) is dependent on the level of personal anxiety, depression and asthenia, age and time of HD treatment. CONCLUSION. QL of HD patients is substantially lower as compared to healthy subjects mainly at the expense of the indices of physical health. QL of HD patients is liable to effects of clinical and mental variables. It should be studied in future what underlies the established differences in QL between HD patients from different countries cultural, socialeconomic factors or the medical care quality.

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The authors declare that there are no conflicts of interest present.