Физическое функционирование как предиктор отдаленной общей выживаемости больных на хроническом гемодиализе

ЦЕЛЬ ИССЛЕДОВАНИЯ. Определить, насколько показатели качества жизни (КЖ) связаны с долгосрочной общей выживаемостью российских больных, получающих лечение гемодиализом (ГД). ПАЦИЕНТЫ И МЕТОДЫ. Проведено длительное проспективное исследование 255 больных, находившихся на лечении ГД. Перед началом исследования у всех больных были определены параметры КЖ по методике SF-36 и клинические показатели с целью оценки их прогностической значимости в отношении выживаемости. РЕЗУЛЬТАТЫ. Медиана периода наблюдения составила 45,9 (22,3; 91,3) мес, максимальная его продолжительность - 13,8 года. В группе умерших больных (n=133) были достоверно ниже семь из восьми исходных показателей КЖ; по исходному показателю психического здоровья различия между группами выживших и умерших не достигли степени статистической значимости. Показатель физического функционирования (ФФ) был независимым предиктором отдаленной общей выживаемости больных на ГД в мультивариантной модели Кокса при ее коррекции по другим потенциальным клиническим факторам риска. Другие параметры КЖ независимой связи с долгосрочной выживаемостью не имели. ЗАКЛЮЧЕНИЕ. Показатель ФФ является прогностическим показателем фактором, связанным с отдаленной выживаемостью больных на ГД.

гемодиализ, выживаемость, качество жизни, физическое функционирование

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