残余肾功能与维持性血液透析患者认知功能关系的研究  

Association of residual renal function with cognitive function among maintenance hemodialysis patients

作　　者：庞娇阳 张炜晨 黄碧红[1] 范春燕 曹艳佩 张倩[1] 施君 陈靖[1] 王梦婧[1] PANG Jiao-yang;ZHAGN Wei-chen;HUANG Bi-hong;FAN Chun-yan;CAO Yan-pei;ZHANG Qian;SHI Jun;CHEN Jing;WANG Meng-jing(Division of Nephrology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Nursing,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院肾脏科,上海200040 [2]复旦大学附属华山医院护理部,上海200040

出　　处：《中国血液净化》2021年第2期91-95,共5页Chinese Journal of Blood Purification

基　　金：上海市自然科学基金(16ZR1449400);国家自然科学基金(81600577)。

摘　　要：目的探索维持性血液透析患者认知功能障碍的危险因素及残余肾功能与认知障碍之间的关系。方法入选维持性血液透析患者93例,其中有残余肾功能的患者31例,无残余肾功能患者62例,收集患者相关资料,并进行蒙特利尔认知评估基础量表(Montreal cognitive assessment basis scale,MOCA-B)认知功能评分。应用Logistic回归分析维持性血液透析患者认知障碍的危险因素。结果受试者平均年龄为(61.62±11.90)岁,51.6%为男性。有残余肾功能组MOCA-B评分高于无残余肾功能组[(24.61±3.58)比(22.11±5.75),t=-2.360,P=0.020]。多因素Logistic回归分析结果提示,高龄(OR=0.906,95%CI:0.854~0.961,P=0.001)、中性粒细胞百分比升高(OR=0.865,95%CI:0.790~0.948,P=0.002)增加认知障碍风险,男性(OR=3.572,95%CI:1.146~11.136,P=0.028)、残余尿量多(OR=4.243,95%CI:1.214~14.827,P=0.024)降低认知功能障碍的风险。结论残余肾功能是认知功能减退的保护因素。Objective To explore the risk factors of cognitive dysfunction in maintenance hemodialysis(MHD)patients and the relationship between residual renal function and cognitive dysfunction.Methods A total of 93 MHD patients were enrolled in this study,including 31 patients with residual renal function and 62 patients without residual renal function.All patients received Montreal Cognitive Assessment Basic Scale(MOCA-B)examination and their clinical data were collected.Logistic regression was used to analyze the risk factors of cognitive impairment.Results The mean age of the patients was 61.62±11.90 years old,and51.6%were males.The MOCA-B score of residual renal function group was significantly higher than that of non-residual renal function group(24.61±3.58 vs.22.11±5.75;t=-2.360,P=0.020).Multivariate logistic regression analysis showed that age(OR=0.906,95%CI:0.854~0.961;P=0.001),neutrophil percentage(OR=0.865,95%CI:0.790~0.948;P=0.002),male(OR=3.572,95%CI:1.146~11.136;P=0.028),and residual urine volume(OR=4.243,95%CI:1.214~14.827;P=0.024)were the independent risk factors of cognitive impairment.Conclusion Residual renal function is one of the protective factors of cognitive dysfunction.

关 键 词：残余肾功能 认知障碍 维持性血液透析 中性粒细胞百分比 男性 

分 类 号：R459.5[医药卫生—治疗学]