动静脉内瘘失功对血液透析患者抑郁情况的影响  

Influence of fistula dysfunction on the depression state in patients with maintenance hemodialysis

作　　者：袁莉[1] 沈燕[2] 丁文彬[3] 范亚平[1] 

机构地区：[1]南通大学附属医院肾内科,江苏南通226001 [2]南通大学第二附属医院肾内科,江苏南通226001 [3]南通大学第二附属医院介入科,江苏南通226001

出　　处：《实用临床医药杂志》2016年第23期50-53,共4页Journal of Clinical Medicine in Practice

基　　金：国家自然科学青年基金项目(No.81200490);江苏省"六大人才高峰"第九批高层次人才(2013-WSN-072)

摘　　要：目的调查维持性血液透析(MHD)患者内瘘失功对抑郁状态的影响。方法应用Bedk抑郁自评量表(BDI)对92例MHD患者进行抑郁状态评估,分为内瘘失功组46例及内瘘通畅组46例,同时收集患者的一般临床资料、社会背景资料及实验室检查结果,探讨抑郁症状及其相关因素。结果 BDI测定结果显示,92例MHD患者中抑郁症状的发生率为87%。失功组BDI评分显著大于通畅组BDI评分(P<0.05),2组患者抑郁程度存在显著差别(P=0.008)。与通畅组相比,失功组无抑郁患者比例显著较低(P=0.011),但重度抑郁患者比例显著增高(P=0.011),2组轻、中度抑郁的发生率相似。2组患者在性别、年龄、透析时间、就职情况以及血红蛋白、血白蛋白、血磷及i PTH方面差异无统计学意义(P>0.05)。CRP在内瘘失功组(15.4±5.3),显著高于内瘘通畅组(4.56±0.89)(P<0.05)。结论内瘘失功的MHD患者抑郁症状发生率及严重程度要高于内瘘通畅MHD患者。Objective To investigate the influence of fistula dysfunction on the depression state in maintenance hemodialysis （MHD） patients. Methods Ninety-two patients with MHD were selected in this study and were evaluated by Beck Depression Inventory （BDI）. They were divided into dysfunctional fistula group and functional fistula group, 46 cases in each group. Their basic clini- cal information, demographic characteristics and laboratory parameters were also collected and ana- lyzed. Results Based on the BDI, 77 cases （87%） were identified as depression symptoms in 92 MHD patients. The BDI scores were significantly higher in dysfunctional fistula group than functional fistula group （P 〈 0.05 ）. There was significant difference in the degree of depression between two groups （P = 0. 008）. Compared with functional fistula group, the dysfunctional fistula group had low- er depression score （P = 0.011 ） and higher proportion of MHD patients with severe depression （ P = 0.011 ）. The incidence rate of mild depression was similar between two groups. There were no signif- icant differences in gender, age, duration of dialysis, hemoglobin, working condition, serum albu- min, phosphorus and iPTH between two groups. Serum CRP was （ 15.4 ± 5.3 ） in dysfunctional fistu- la group, which was significantly higher than （4.56 ± 0.89 ） in functional fistula group （P 〈 0.05 ）. Conclusion The incidence rate and severity of depression are higher in MHD patients with dysfunc- tional fistula than the patients with functional fistula.

关 键 词：抑郁症 尿毒症 内瘘 血液透析 

分 类 号：R459.5[医药卫生—治疗学]