老年维持性血液透析合并认知功能障碍相关危险因素研究  

Risk factors of cognitive dysfunction in elderly patients undergoing maintenance hemodialysis

作　　者：钟成 赵亚亚 赵卫红 ZHONG Cheng,ZHAO Ya-ya,ZHAO Wei-hong(Division of Nephrology,Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital,Nanjing 210029, Chin)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院老年肾科,南京210029

出　　处：《中国医学前沿杂志（电子版）》2018年第6期135-138,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家重点基础研究发展计划(2013CB530803);江苏省333高层次人才培养工程(BRA2017409);江苏省老年医学重点实验室;江苏省医学重点人才项目(ZDRCA2016021);江苏高校优势学科建设工程资助项目(JX10231801)

摘　　要：目的探讨老年维持性血液透析患者认知功能障碍的相关危险因素。方法回顾性分析2015年1月至2017年12月本院收治的105例老年维持性血液透析患者的临床资料,根据蒙特利尔认知评估量表(Montreal cognitive assessment,Mo CA)评分结果将患者分为认知功能障碍组和非认知功能障碍组,探讨影响维持性血液透析患者认知功能的危险因素。结果105例老年维持性血液透析患者中,55例Mo CA评分<26分,认知功能障碍发生率为52.38%。两组患者性别、年龄、文化程度、血钙、空腹血糖及空腹胰岛素水平比较差异均无显著性(P>0.05)。多因素Logistic回归分析结果显示血红蛋白和空腹C肽水平降低及透析前后体重变化过快均是老年维持性血液透析患者认知功能障碍的独立危险因素(P<0.05)。结论老年维持性血液透析患者认知功能障碍发病率较高,而中度贫血、胰岛素抵抗、透析过程中体重明显变化与老年患者认知功能减退关系密切。Objective To explore the related risk factors of cognitive dysfunction in elderly maintenance hemodialysis patients. Method Retrospectively analyzed the clinical data of 105 elderly patients with maintenance hemodialysis from January 2015 to December 2017 in our hospital, the patients were divided into cognitive dysfunction group and non-cognitive dysfunction group according to the Montreal cognitive assessment（Mo CA） and explored the risk factors of cognitive function in maintenance hemodialysis patients. Result Among 105 patients, 55 patients gained Mo CA score 26 point, the incidence of cognitive dysfunction was 52.38%. There were no significant differences in gender, age, education level, blood calcium, fasting blood glucose and fasting insulin level between the two groups（P〈0.05）. Multiple factor Logistic regression analysis showed that the decrease hemoglobin and fasting C peptide levels and excessive body weight changes before and after dialysis were independent risk factors for cognitive impairment in elderly maintenance hemodialysis patients（P〉0.05）. Conclusion The incidence of cognitive dysfunction in elderly patients with maintenance hemodialysis is higher, while moderate anemia, insulin resistance, and significant changes in body weight during dialysis process are closely related to cognitive dysfunction of elderly maintenance hemodialysis patients.

关 键 词：老年患者 维持性血液透析 认知功能障碍 

分 类 号：R692.5[医药卫生—泌尿科学] R749.1[医药卫生—外科学]