生活方式干预对早中期慢性肾脏病患者肾功能的影响

Effect of Life Style Intervention on Renal Function of Patients with CKD 2 and CKD 3

中文关键词: 生活方式  慢性肾病  健康教育  肾功能

英文关键词: life style  chronic kidney diseases (CKD)  health education  renal function

中文摘要:

      目的 生活方式干预对早中期慢性肾脏病患者肾功能的影响,以评价以社区家庭医生为主的团队防治慢性肾脏病的新模式的运行效果.方法 选取长宁区仙霞社区家庭医生管理的早中期慢性肾脏病患者380名,完成所有检查项目343名,干预组(n=189)和对照组(n=154).采用非随机同期对照试验,干预组予以额外强化的干预措施,对照组不予以额外的干预措施,观察时间12个月(设计观察表格),每半年检查血肌酐一次(基线、6个月和12个月共3次),应用MDRD-eGFR公式评估肾功能,并对干预前后生活方式情况进行调查记录.结果 343例患者干预组189例,对照组154例,男性163例,女性180例,平均年龄64.3±10.3岁.其中高血压患者52.8％(181例),糖尿病9.3％(32例),高血压合并糖尿病37.9％(130例).经过强化的生活方式干预,干预组的均衡饮食率、增加体育锻炼者较对照组明显上升,2组间的差异存在统计学意义(P＜0.05);在干预组患者MDRD-eGFR有所升高,其差异存在统计学意义(P＜0.01);而对照组在基线时间、12月eGFR差异无统计学意义(P＞0.05).在基线时间2组间eGFR差异无统计学意义(P＞0.05),随着干预治疗2组间同期肾功能出现明显差异存在统计学意义(P＜0.05).结论 强化的社区生活方式干预能有效改善肾功能,延缓CKD进展,对于社区CKD患者进行有效的生活干预势在必行.

英文摘要:

      Objeetive To evaluate the operation effect of the new model team work mainly with community family doctors in preventing and treating chronic kidney diseases (CKD) by exploring the effect of life style intervention on renal function of patients with CKD2 and CKD3.Methods Out of 380 selected patients with CKD from Xianxia Community,Changning District under the control of family doctors,343 patients finished all the examination items and were divided into 2groups:intervention group (n=189) and control group (n=154);as a non-random concurrent controlled trial,additional intensive intervention was applied to patients in intervention group and no to patients in control group;the observation lasted for 12 months and detection of serum creatinine was made once half a year (in total,3 times:at the time point of baseline,the 6th months and the 12th months);MDRD-eGFR was used to evaluate the renal function and the life styles before and after intervention were recorded.Results After intervention,the rate of balanced diet and the number of people taking physical exercises in intervention group increased obviously,higher and bigger than those in control group,the difference between the 2 groups was of statistical significance (P＜0.05);the MDRD-eGFR of the patients in intervention group increased with time going,the difference among the time points was of statistical significance (P ＜ 0.01) while the difference in eGFR of the patients in control group at the time point of baseline,the 6th month and the 12th month was of no statistical significance (P＞0.05);there existed no statistical difference in eGFR at the time point of baseline between the 2 groups (P＞0.05) while with intervention performance,the renal function of the same period showed out a statistical difference between the patients of the 2 groups (P ＜ 0.05).Conclusions To strengthen the community life style intervention can effectively improve the renal function of the patients with CKD and delay the disease progress.