老年维持性血液透析患者认知衰弱现状并探讨其主要发生影响因素  

Status of Cognitive Weakness in Elderly Patients with Maintenance Hemodialysis and Discussion on Main Influencing Factors

作　　者：王碧月 吴秋杰[1] 梁冰[1] 张靖华[1] Wang Biyue;Wu Qiujie;Liang Bing;Zhang Jinghua(Department of Nephrology of Kidney Transplantation,Zhengzhou No.7 People's Hospital,Zhengzhou 450006)

机构地区：[1]郑州市第七人民医院肾移植肾内科,郑州450006

出　　处：《数理医药学杂志》2022年第5期690-693,共4页Journal of Mathematical Medicine

摘　　要：目的:分析老年维持性血液透析患者认知衰弱现状,探讨引起认知衰弱的主要影响因素。方法:选择2019年3月-2021年3月某院收治的100例老年维持性血液透析患者,通过蒙特利尔认知评估量表(MoCA评分)、Fried衰弱表型量表、临床痴呆评定量表(CDR评分)评估患者是否存在认知衰弱。并搜集认知衰弱组患者、无认知衰弱组患者的性别、文化水平、年龄、病史等详细资料,分析导致患者认知衰弱的影响因素。结果:100例老年维持性血液透析患者中有23例患者存在认知衰弱,认知衰弱发生率为23.0%。单因素分析显示,年龄>75岁、血液透析时间>3年、合并疾病≥3个、中重度抑郁、有脑卒中病史的患者认知衰弱发生率显著高于年龄≤75岁、血液透析时间≤3年、合并疾病≤2个、轻度或无抑郁、无脑卒中病史的患者,差异有统计学意义(P<0.05);Logistic多因素回归法分析结果显示,年龄>75岁、合并疾病≥3个、中重度抑郁、有脑卒中病史是认知衰弱的独立危险因素(P<0.05)。结论:老年维持性血液透析患者容易发生认知衰弱,合并疾病数量多、高龄、中重度抑郁、有脑卒中病史是引起认知衰弱的危险因素。重视认知衰弱的危害,早期识别影响因素,采取干预措施可降低认识衰弱发生率。Objective:To analyze the status of cognitive weakness in elderly patients with maintenance hemodialysis,and explore the main influencing factors of cognitive weakness.Methods:100 elderly patients with maintenance hemodialysis admitted in a hospiatl from March 2019 to March 2021 were seletcted.Through the Montreal Cognitive Assessment Scale(MoCA Scale),Fried Deficiency Phenotype Scale,and Clinical Dementia Assessment Scale(CDR Scale),the status of cognitive weakness in patients was evaluated.The detailed data such as gender,cultural level,age and medical history of patients in cognitive weakness group and no cognitive weakness group were collected,and the influencing factors leading to patient cognitive weakness were analyzed.Results:23 of 100 elderly maintenance hemodialysis patients had cognitive weakness,and the incidence of cognitive weakness was 23.0%.Univariate analysis showed that the incidence of cognitive weakness of patients with age>75 years old,hemodialysis time>3 years,complicated with disease≥3,moderate-severe depression,and history of stroke were significantly higher than that of patients with age≤75years old,hemodialysis time≤3years,combined disease≤2,mild or no depression,and no history of stroke,and the difference was statistically significant(P<0.05).Logistic multivariate regression analysis showed that age>75 years old,combined disease≥3,moderate-severe depression,and history of stroke were the independent risk factors for cognitive weakness(P<0.05).Conclusion:Elderly maintenance hemodialysis patients are prone to cognitive weakness,and the large number of combined diseases,old age,moderate to severe depression,and stroke history are the risk factors for cognitive weakness.Focusing the harm of cognitive weakness,identifying the influencing factors early,and taking intervention can reduce the incidence of cognitive weakness.

关 键 词：影响因素 老年患者 维持性血液透析 认知衰弱 现状 

分 类 号：R692.5[医药卫生—泌尿科学]