不同肾替代方法治疗终末期肾病患者焦虑抑郁及认知功能状况调查

Investigation on anxiety, depression and cognitive function of end-stage renal disease patients treated with different renal replacement therapy

  • 摘要: 目的 比较维持性血液透析、腹膜透析及肾移植治疗终末期肾病患者焦虑抑郁及认知功能状况。方法 于2015年6月- 2017年12月对首都医科大学附属北京朝阳医院就诊的418例终末期肾病患者进行调查,其中维持性血液透析患者160例,男性85例,平均年龄(51.1±12.5)岁;腹膜透析患者108例,男性63例,平均年龄(51.3±14.4)岁;肾移植患者150例,男性81例,平均年龄(50.2±16.5)岁;所有对象均完成包括基本信息的一般资料问卷、综合医院焦虑抑郁自评量表(hospital anxiety and depression scale,HADS)、简易智力状况检查表(mini-mental state examination,MMSE)调查。结果 肾移植患者的HADS评分(9.43±5.62)显著低于维持性血液透析组(19.01±5.65)和腹膜透析组(16.77±5.21)(P均<0.001),维持性血液透析组的HADS评分高于腹膜透析组(P<0.01)。肾移植患者MMSE评分(27.19±2.23)高于维持性血液透析组(22.14±2.15)和腹膜透析组(25.35±2.44)(P均<0.001),腹膜透析组的MMSE评分高于维持性血液透析组(P<0.05)。结论 本研究发现肾移植患者的认知和情绪调节效果优于维持性血液透析和腹膜透析组患者。

     

    Abstract: Objective To compare the levels of anxiety, depression and cognitive function of end-stage renal disease between patients treated by maintenance hemodialysis, peritoneal dialysis and kidney transplantation (KT). Methods Totally 418 patients with end-stage renal disease admitted to Beijing Chaoyang Hospital from June 2015 to December 2017 were investigated. Of the 418 cases, 160 patients were treated with maintenance hemodialysis, including 85 males and 75 females with an average age of 51.1±12.5 years; peritoneal dialysis was performed in 108 patients, including 63 males and 45 females with an average age of 51.3±14.4 years; renal transplantation was performed in 150 patients, including 81 males and 69 females with an average age of 50.2±16.5 years. All participants were given a detailed sociodemographic form, Hospital Anxiety and Depression Scale (HADS) for evaluating depressive and anxiety symptoms, and the mini-mental state examination (MMSE) for detecting possible cognitive impairment. Results Patientstreated with KT had significantly lower levels of anxiety and depression symptoms (HADS, 9.43±5.62) than patients with maintenance hemodialysis (HADS, 19.01±5.65) and peritoneal dialysis (HADS, 16.77±5.21) (P<0.05). The KT group (27.19±2.23) scored higher than the maintenance hemodialysis group (22.14±2.15) and the peritoneal dialysis group (25.35±2.44) on the MMSE (P<0.05). The maintenance hemodialysis group scored higher on the HADS than the peritoneal dialysis group (P<0.01), while the peritoneal dialysis group scored higher on the MMSE than the maintenance hemodialysis group (P<0.01). Conclusion In this study, we find that KT patients have better cognitive and mood regulation outcomes than maintenance hemodialysis and peritoneal dialysis patients with chronic kidney failure.

     

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