透析患者临床指标与抑郁及认知功能关系的研究

李大妹; 贺美玲; 王海燕; 邱宏; 沙菲菲; 荀康; 贾苗; 卢国元; 徐德宇; 金东华

doi:10.7619/jcmp.20211967

透析患者临床指标与抑郁及认知功能关系的研究

Relations between clinical parameters and depression as well as cognitive function among dialysis patients

摘要

摘要:
目的探讨透析患者的主要临床指标与抑郁及认知功能障碍的相关性。
方法回顾性分析186例透析（包括血液透析和腹膜透析）患者的临床资料，应用汉密尔顿抑郁量表-24（HAMD-24）和临床痴呆评定量表（CDR）对患者的抑郁和认知功能情况进行评分。采用Pearson双变量相关分析探讨患者基本临床指标与抑郁水平及认知功能的相关性。采用多元线性回归分析探讨透析患者抑郁及认知功能障碍的独立危险因素。
结果 186例透析患者中，75例（40.32%）患有中度或重度抑郁。血液透析和腹膜透析患者的年龄、血压、白蛋白、β₂微球蛋白水平比较，差异有统计学意义（P < 0.05）。舒张压、血红蛋白、血清磷、白蛋白、β₂微球蛋白水平和CDR评分均与患者抑郁症状具有相关性；年龄、舒张压和血清磷水平与患者认知功能障碍具有相关性。高血清磷水平是抑郁和认知功能障碍的独立危险因素。
结论终末期肾病透析患者易发生抑郁症及认知功能障碍，血清磷水平升高是与抑郁状态及认知功能障碍均有关联的独立危险因素。

Abstract:
Objective To explore the relations between clinical parameters and depression as well as cognitive function among dialysis patients.
Methods The clinical data of 186 dialysis patients(including hemodialysis and peritoneal dialysis) was retrospectively analyzed. The depression and cognitive function of patients were scored using Hamilton Depression Scale-24 (HAMD-24) and Clinical Dementia Rating Scale (CDR), respectively. Pearson bivariate correlation analysis was used to explore the correlation between basic clinical indicators and depression level, cognitive function. Multiple linear regression analysis was used to investigate the independent risk factors of depression and cognitive dysfunction in dialysis patients.
Results Of the 186 dialysis patients, 75 people (40.32%) had moderate or severe depression. There were significant differences in age, blood pressure, albumin and β₂ microglobulin levels between hemodialysis and peritoneal dialysis patients(P < 0.05). Diastolic blood pressure, hemoglobin, phosphorus, albumin, β₂ microglobulin, CDR scores were correlated with depression. Age, diastolic blood pressure and phosphorus levels were associated with cognitive impairment. High phosphorus was an independent risk factor for both depression and cognitive dysfunction.
Conclusion Dialysis patients with end-stage renal disease are prone to present depression and cognitive dysfunction. Increase of serum phosphorus level is the independent risk factor associated with both depression and cognitive dysfunction.

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