中青年终末期肾脏病维持性血液透析患者认知功能改变及相关影响因素分析  

Analysis of cognitive function and related factors in young and mlddle-aged maintenance hemodialysis patients with end-stage renal disease

作　　者：姜玲[1] 孔慧[1] 张洁[1] 金凤[1] 李莉[1] 

机构地区：[1]青岛市市立医院血液净化中心,山东青岛266011

出　　处：《中国医学前沿杂志（电子版）》2017年第2期150-153,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析中青年终末期肾脏病维持性血液透析患者认知功能改变及相关影响因素。方法选取本院2015年9月至2016年9月收治的中青年终末期肾脏病维持性血液透析患者87例为研究对象。采用蒙特利尔认知评估量表(Montreal cognitive assessment,Mo CA)评价患者的认知功能,调查入选患者的临床资料,包括年龄、透析龄、是否伴高血压和糖尿病、血尿素氮和血肌酐水平,分析认知功能障碍的发生情况及影响因素。结果 87例中青年终末期肾脏病维持性血液透析患者中发生认知功能障碍62例(71.26%)纳入认知功能障碍组,其余患者纳入认知功能正常组。认知功能障碍组患者的定向力、抽象能力、语言、注意力、记忆、命名、视空间/执行功能及Mo CA总分均低于认知功能正常组(P<0.05)。单因素分析表明,两组患者的性别比例、伴高血压和糖尿病患者比例及血尿素氮和血肌酐水平比较均无显著差异(P>0.05);认知功能障碍组中年龄≥40岁和透析龄≥4年的患者比例均显著高于认知功能正常组(P<0.05)。多因素回归分析结果显示,年龄≥40岁和透析龄≥4年为终末期肾脏病维持性血液透析患者发生认知功能障碍的独立危险因素(P<0.05)。结论中青年终末期肾脏病维持性血液透析患者认知功能障碍发生率较高,而年龄≥40岁和透析龄≥4年为认知功能障碍发生的独立危险因素。Objective To analyze the changes of cognitive function and related factors in maintenance hemodialysis patients with end-stage renal disease （ESRD）. Method A total of 87 patients with ESRD underwent maintenance hemodialysis （MHD） in our hospital from September 2015 to September 2016 were selected as the research subjects. The Montreal cognitive assessment （MoCA） was used to assess cognitive function, and investigated clinical data （including age, dialysis age, hypertension, diabetes mellitus, blood urea nitrogen, serum creatinine）, analyzed the cognitive impairment and the related factors. Result 87 cases of ESRD MHD patients had cognitive dysfunction in 62 （71.26%）, which were enrolled in the cognitive dysfunction group, the others were enrolled in the normal cognitive function group; orientation, abstract ability, language, attention, memory, naming, visual space and executive function and MoCA score in the cognitive dysfunction group were lower than the normal cognitive function group （P 〈 0.05）; single factor analysis showed no statistically significant difference between the two groups in gender, hypertension, diabetes, hypertension and serum creatinine （P 〉 0.05）; the proportion of patients aged 40 years and above in the cognitive dysfunction group was significantly higher than the normal cognitive function group, the proportion of patients with 4 years dialysis age and above in the cognitive dysfunction group was significantly higher than the normal cognitive function group （P 〈 0.05）; the multiple regression analysis showed that the age of 40 years and above and the dialysis age of 4 years and above were independent risk factors for ESRD MHD patients with cognitive dysfunction. Conclusion The incidence of cognitive dysfunction in young and middle-aged maintenance hemodialysis patients with end-stage renal disease is higher. the age of 40 years and above and the dialysis age of 4 years and above were independent risk factors for cognitive dysfunction.

关 键 词：终末期肾脏病 维持性血液透析 认知功能 影响因素 

分 类 号：R692[医药卫生—泌尿科学]