维持性血液透析患者人体成分分析与认知功能相关性研究  

Correlation between body composition analysis and cognition in maintenance hemodialysis patients

作　　者：程惠玲[1] 卜文夺 马屹茕 石明[1,2] 杨定平 Cheng Hui-ling;Bu Wen-duo;Ma Yi-qiong;Shi Ming;Yang Ding-ping(Department of Nephrology,Renmin Hospital,Wuhan University,Wuhan 430060,China;Hubei Provin-cial Clinical Research Center of Kidney Disease,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院肾内科,武汉430060 [2]湖北省肾脏病临床医学研究中心,武汉430060

出　　处：《临床肾脏病杂志》2022年第3期190-194,共5页Journal Of Clinical Nephrology

基　　金：国家自然科学基金(81670631)。

摘　　要：目的利用人体成分监测仪(body composition monitor,BCM)测量维持性血液透析(maintenance hemodialysis,MHD)患者人体成分相关指标,分析其测量结果与认知功能的相关性。方法选取2019年5月至2019年12月在武汉大学人民医院行MHD治疗的慢性肾功能不全患者106例,收集一般临床资料,并使用BCM对患者进行人体成分分析测定,包括水负荷(over hydration,OH)、脂肪组织指数(fat tissue index,FTI)、瘦肉组织指数(lean tissue index,LTI)、体重指数(body mass index,BMI)、全身总液量(total body water,TBW)、细胞外液量(extracellular water,ECW)及细胞内液量(intracellular water,ICW)等指标,并对测量结果进行分析。使用蒙特利尔认知评估量表(MoCA)评估患者认知功能,并根据认知功能评分将患者分为认知功能正常组和认知功能障碍组,比较两组患者人体成分分析指标结果差异性,并分析人体成分分析结果与认知功能的相关性。结果在研究入组的106例MHD患者中,通过人体成分分析监测仪测得的结果分析所得相对水负荷(OH与ECW的比值,OH/ECW)、身高矫正的细胞外液量(ECW与身高的比值,ECW/H)、LTI、ICW以及患者年龄、透析龄在认知功能正常组与认知功能障碍组之间的差异有统计学意义(P<0.05)。多元线性回归分析显示:年龄(P=0.007),OH/ECW(P=0.044),ECW/H(P=0.001),LTI(P=0.000)与认知功能减退有关。结论BCM测量的人体成分指标中OH/ECW,ECW/H,LTI与维持性透析患者的认知功能障碍显著相关;OH/ECW越大,ECW/H越多,LTI越低的患者认知功能越差。Objective To employ body composition monitor(BCM)to measure body composition in patients with maintenance hemodialysis(MHD)and examine the correlation between measurement results and cognitive function.Methods From May 2019 to December 2019,a total of 106 patients with chronic renal failure(CRF)receiving MHD were selected.Their general clinical data were collected.Various parameters of body composition were analyzed by BCM,including overhydration(OH),fat tissue index(FTI),lean tissue index(LTI),body mass index(BMI),total body water(TBW),extracellular water(ECW)and intracellular water(ICW).Montreal Cognitive Assessment Scale(MoCA)was employed for assessing cognitive function.Based upon the cognitive function score,they were divided into two groups of normal cognitive function and cognitive dysfunction group.And correlation between body composition and cognitive function was examined.Results Significant inter-group differences existed in age,duration of dialysis,OH/ECW,ECW/H,LTI and ICW(P<0.05).Multiple linear regression analysis indicated that age(P=0.007),OH/ECW(P=0.044),ECW/H(P=0.001)and LTI(P=0.000)were correlated with cognitive impairment.Conclusion Age,OH/ECW,ECW/H and LTI are significantly associated with cognitive dysfunction in MHD patients.Advanced age,higher levels of OH/ECW and ECW/H and lower level of LTI were accompanied with worse cognition.

关 键 词：维持性血液透析 人体成分分析 认知功能障碍 

分 类 号：R692.5[医药卫生—泌尿科学]