维持性血液透析患者抑郁状态与蛋白质能量消耗的相关性分析  

Correlation between depression and protein-energy wasting in patients undergoing hemodialysis

作　　者：彭新涛[1] 朱筱 张丽[3] 杨雪花 廖汉文 桑晓红[3] 张健[3] 付高宁 PENG Xintao;ZHU Xiao;ZHANG Li;YANG Xuehua;LIAO Hanwen;SANG Xiaohong;ZHANG Jian;FU Gaoning(Air Navigation Center,Xinjiang Branch,China Southern Airlines Co.Ltd,Urumqi 830016,China;Department of Psychiatry,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Nephrology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Xinjiang Yili State Hospital of Traditional Chinese Medicine,Xinjiang Yili 835000,China;Xinjiang Yili Kazakh Autonomous Region Friendship Hospital,Xinjiang Yili 835000,China)

机构地区：[1]中国南方航空股份有限公司新疆分公司航卫中心,乌鲁木齐830016 [2]新疆医科大学第一附属医院心理医学科,乌鲁木齐830054 [3]新疆医科大学第一附属医院肾病科,乌鲁木齐830054 [4]新疆伊犁哈萨克自治州中医医院,新疆伊宁835000 [5]新疆伊犁哈萨克自治州友谊医院,新疆伊宁835000

出　　处：《新疆医科大学学报》2020年第5期601-606,共6页Journal of Xinjiang Medical University

基　　金：中华医学会施维雅基金(15020080596)。

摘　　要：目的研究维持性血液透析(maintenance hemodialysis,MHD)患者抑郁的临床特征,分析透析患者抑郁的相关危险因素。方法选取2016年1月-2017年3月在新疆医科大学第一附属医院、新疆伊犁哈萨克自治州中医医院和新疆伊犁哈萨克自治州友谊医院血液透析中心的218例患者作为研究对象,根据Zung抑郁自评量表(self-rating depression scale,SDS)将研究对象分为抑郁组(轻度、中度、重度)和非抑郁组,采用患者自评-主观全面评定(PG-SGA)量表测评蛋白质能量消耗(protein-energy wasting,PEW),比较各组间患者的一般资料及实验室指标、PEW检出率等之间的差异。建立Logistic回归模型分析血液透析患者抑郁的危险因素。结果抑郁患者的检出率为60.6%,抑郁组PEW检出率为77.3%,非抑郁组为53.5%,差异有统计学意义(P<0.05);非抑郁组血清白蛋白(albumin,ALB)水平、血肌酐水平均高于不同程度的抑郁组(P<0.05)。多因素Logistic回归模型分析显示,低白蛋白血症、低水平血肌酐、PEW为血液透析患者抑郁的危险因素。结论血液透析患者抑郁状态较为常见,而PEW、低血清白蛋白、低水平血肌酐与MHD患者的抑郁密切相关。Objective To explore the characteristics of depression and analyze the risk factors in maintenance hemodialysis(MHD)patients.Methods A total of 218 MHD patients recruited from 3 dialysis centres in the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Yili State Hospital of Traditional Chinese Medicine and Xinjiang Yili Kazakh Autonomous Region Friendship Hospital with non-probability sampling method between Jaruary 2016 to March 2017.The subjects were divided into depression group(mild,moderate and severe)and non-depression group using Zung Self-rating depression scale(SDS).Protein-energy wasting(PEW)was assessed using the Scored Patient-Generated Subjective Global Assessment(PG-SGA)scale.The differences of general information and the detection rate of PEW between the 4 groups were compared,and the risk factors of depression were analyze by multivariable binary Logistic regression model.Results The detection rate of depression patients was 60.6%.The detection rate of PEW in the depression group was 77.3%,which was higher than that in the non-depression group(53.5%)(P<0.05).Albumin levels and serum creatinine levels were higher in the non-depressed group than in the depressed group(P<0.05).Multivariable Logistic regression model analysis showed that hypoalbuminuria,low serum creatinine and PEW were risk factors for depression.Conclusion MHD patients commonly experience the depression.There is a close association between depression and PEW,as well as hypoalbuminuria,low serum creatinine in MHD patients.

关 键 词：维持性血液透析 抑郁 蛋白质能量消耗 

分 类 号：R692.5[医药卫生—泌尿科学]