腹膜透析患者产生抑郁的风险因素分析  

Influence factors in peritoneal dialysis patients with depression

作　　者：卢素玉[1] 李哲[2] 穆霖[1] 吴晓磊[1] 李绍梅[1] 傅淑霞[1] 

机构地区：[1]河北医科大学第二医院肾内科,河北石家庄050000 [2]河北大学附属医院肾内科,河北保定071000

出　　处：《河北医科大学学报》2015年第10期1117-1119,1128,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(ZL20140173)

摘　　要：目的分析腹膜透析患者精神抑郁的发生率及其发生的危险因素,以改善患者生活质量。方法选取进行腹膜透析治疗时间>3个月的患者120例,采用健康状况调查问卷(Short From 36 Health Survey Questionnaire,SF-36)及抑郁自评量表(Self-rating Depression Scale,SDS)对患者进行评估。记录评估前后1个月内患者的相关指标,包括营养状况、微炎症、是否存在心血管事件、残余肾功能、透析充分性。将血白蛋白(albumin,Alb)<35g/L,C反应蛋白(C-reaction protein,CRP)>8mg/L,是否发生过心血管事件作为3个变量对腹透患者进行分组:第1组,三类因素均不存在;第2组,三类因素中存在任意1项;第3组,三类因素中存在任意2项或2项以上。分别做多元线性回归分析及二元Logistic回归分析。结果抑郁的发生率为55.83%(67/120),男性占45.09%(23/51),女性占63.77%(44/69)。多元线性回归结果表明:分组情况及腹膜透析治疗时间的长短是抑郁的危险因素。Logistic回归分析显示:分组情况与抑郁呈显著相关;分组中存在ALb<35g/L、CRP>8g/L、发生过心血管事件3种因素越多,抑郁评分越高;进行腹膜透析治疗时间越长抑郁评分越高;残余肾功能是抑郁的保护因子(OR=0.631)。结论腹膜透析患者抑郁发生率较高,女性比男性发生抑郁比例高。腹膜透析患者合并营养不良、微炎症状态、心血管事件越多,发生抑郁的概率越高。Objective To analyze the incidence and risk factors of peritoneal dialysis patients with depression,in order to improve the quality of life in the patients.Methods The study enrolled 120 cases of peritoneal dialysis time（dialysis age）more than 3months,from a peritoneal dialysis center in Hebei Province.The patients were evaluated by the Short From 36 Health Survey Questionnaire（SF-36）and Self-rating Depression Scale（SDS）.The indicators included nutritional status,inflammation,cardiovascular events,residual renal function,and dialysis adequacy in one month of peritoneal dialysis patients.All patients were divided into three groups according to plasma albumin（Alb）（ 〈35 g/L）,C-reaction protein（CRP）（ 〉8 mg/L）,cardiovascular events.Group one did not have the three factors,group two had any one of three factors,and group three had any two or three factors.Results The incidence of depression was55.83%（67/120）,men 45.09%（23/51）,women 63.77%（44/69）.The multiple linear regression showed the grouping condition and dialysis age as risks for depression.The more the group with Alb〈35g/L,CRP〉8mg/L,cardiovascular events,the greater the depression score.Meantime,the longer dialysis age,the higher depression score.The binary Logistic regression analysis：grouping was an independent risk factor for depression and positively correlated with depression.Residual renal function was a protective factor for depression（OR=0.460）.Conclusion Patients with peritoneal dialysis had greater incidence of depression,women more than men.Patients with malnutrition,the inflammatory state,experienced cardiovascular events had higher chance of depression.

关 键 词：腹膜透析 抑郁 生活质量 

分 类 号：R459.5[医药卫生—治疗学]