终末期肾病患者工作记忆功能改变及其相关危险因素分析  

Changes of working memory function and its risk factors in end-stage renal disease patients

作　　者：马雪英[1] 丁墩[1,2] 李朋 张盼[1] 麻少辉 郭乔[1] 张燕[4] 张明 刘红娟[5] MA Xueying;DING Dun;LI Peng;ZHANG Pan;MA Shaohui;GUO Qiao;ZHANG Yan;ZHANG Ming;LIU Hongjuan(Department of Radiology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Radiology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Department of Radiology,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000;Department of Radiology,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000;Intensive Care Unit,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院影像科,陕西西安710061 [2]西安交通大学第二附属医院影像科,陕西西安710004 [3]陕西核工业二一五医院影像科,陕西咸阳712000 [4]宝鸡市中医医院影像科,陕西宝鸡721000 [5]西安交通大学第一附属医院重症医学科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2020年第2期182-187,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省自然科学基础研究计划重大基础研究项目(No.S2017-ZRJJ-ZDXM-0058);西安交通大学第一附属医院临床研究课题重点项目(No.XJTU1AF-CRF-2018-006);宝鸡市科技计划项目(No.16SFGG3-5)~~

摘　　要：目的探讨终末期肾病(end-stage renal disease,ESRD)患者工作记忆功能改变及其相关危险因素。方法纳入2016年8月至2017年12月于西安交通大学第一附属医院就诊的拟行透析治疗的ESRD青中年患者30例及同期健康对照者23例,采用不同负荷n-back工作记忆任务评估所有被试者工作记忆功能,收集一般资料及患者动脉血压、尿毒症毒素等临床资料,分析可能与工作记忆改变相关的危险因素。结果ESRD患者不同负荷下工作记忆任务的反应时均明显高于正常被试(P<0.01),患者组1-back任务的正确率低于正常被试(P<0.01),随着工作记忆负荷的增大,患者组和正常组反应时均呈上升趋势,正确率呈下降趋势。n-back工作记忆负荷与分组的交互作用不显著(P>0.05)。血肌酐、血尿素氮及甲状旁腺素水平与不同负荷工作记忆负荷正确率呈负相关(P<0.05)。结论ESRD患者存在不同负荷下工作记忆功能受损,尿毒症毒素的蓄积可能是ESRD患者工作记忆功能损伤的危险因素。Objective To explore the changes of working memory function and its risk factors in end-stage renal disease(ESRD)patients.Methods We prospectively recruited 30 ESRD patients without dialysis and 23 healthy controls in The First Affiliated Hospital of Xi'an Jiaotong University from August 2016 to December 2017.The n-back working memory task with different loads was used to assess their working memory function;the general information of all the participants,arterial blood pressure and uremic toxins of the patients were collected to analyze the risk factors of working memory changes.Results The reaction time of working memory with different loads was significantly longer than that in the healthy controls(P<0.01),and the accuracy of 1-back was lower than that in the healthy controls(P<0.01).With the increase of memory load,the reaction time was increased while the accuracy was decreased.The interaction between n-back working memory load and grouping was not significant(P>0.05).The correlation analysis showed that serum creatinine,blood urea nitrogen and parathyroid hormone levels were negatively correlated with the accuracy rate of working memory with different loads(P<0.05).Conclusion The working memory function with different loads was impaired in ESRD patients.The accumulation of uremic toxins might be the risk factor for the working memory impairment in ESRD patients.

关 键 词：终末期肾病 工作记忆 N-BACK 尿毒症毒素 危险因素 

分 类 号：R445.2[医药卫生—影像医学与核医学]