维持性血液透析患者认知功能障碍状况及影响因素分析  

The Analysis of Cognitive Impairment among Maintenance Hemodialysis Patients and Its Influencing Factors

作　　者：沈建琴[1] 缪立英[1] 刘金凤[1] 王惠[1] SHEN Jianqin;MIAO Liying;LIU Jinfeng;WANG Hui(The Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院,江苏常州213003

出　　处：《中国医药指南》2023年第21期95-97,共3页Guide of China Medicine

基　　金：常州市科技局应用基础研究项目(CJ20179028);常州市科技局应用基础研究项目(CJ20210090)。

摘　　要：目的调查维持性血液透析患者(MHD)认知功能障碍状况及其相关影响因素分析。方法选取2017年2月至2018年1月在本院行维持性血液透析治疗的92例患者作为研究对象,采用蒙特利尔评估量表(MoCA)行认知功能评估,记录患者年龄、教育水平、干体质量和透析龄等一般资料及白细胞计数(WBC)、血红蛋白(Hb)、红细胞比容(Hct)、血小板计数(PLT)、血尿素氮(BUN)、血肌酐(SCr)、血钙(Ca)、血磷(P)、血清白蛋白(Alb)、血清甲状旁腺激素(iPTH)和血清脑源性神经营养因子(BDNF)等化验指标,并进行统计学比较。结果92例患者中42例(45.65%)存在认知功能障碍。与认知功能正常组比较,认知功能障碍组患者年龄大,教育水平低,Hb、Hct、BDNF水平下降,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄增长(OR=1.138,95%CI 1.020-1.269,P=0.021),教育水平低(OR=13.084,95%CI 2.703-63.338,P<0.01)是MHD患者发生认知功能障碍的独立危险因素。结论MHD患者认知功能障碍患病率高,年龄、教育水平是患者认知功能障碍的独立危险因素,在临床工作中应采取有效措施预防和延缓MHD患者认知功能障碍的发生和发展。Objective To analyze cognitive impairment among maintenance hemodialysis patients and its influencing factors.Methods A total of 92 patients who received maintenance hemodialysis in our hospital from February 2017 to January 2018 were selected as the study subjects and the cognitive function was assessed using the Montreal Cognitive Assessment(MoCA).The general information like age,educational level,dry weight and dialysis duration and a series of assay indexes like white blood cell(WBC)count,hemoglobin(Hb),hematokrit(Hct),platelet(PLT)count,blood urea nitrogen(BUN),serum creatinine(Scr),calcium(Ca),phosphorus(P),albumin(Alb),intact parathyroid hormone(iPTH),serum brain-derived neurotrophic factor(BDNF)were recorded and compared statistically.Results Among the 92 patients,42 patients(45.65%)have cognitive impairment.In comparison with the patients in the group with normal cognitive function,the patients in the group of cognitive impairment are older,less educated and the level of Hb,Hct and BDNF drops.Differences between two groups have statistical significance(P<0.05).Multivariate Logistic regression analysis showed that the growth of age(OR=1.138,95%CI 1.020-1.269,P=0.021)and the lower educational level(OR=13.084,95%CI 2.703-63.338,P<0.01)are independent risk factors of cognitive impairment among maintenance hemodialysis patients.Conclusions The prevalence rate of cognitive impairment is higher among maintenance hemodialysis patients.In addition,age and education level are independent risk factors of cognitive impairment among them.In clinical practice,we should take effective countermeasures to prevent and delay the progress of cognitive impairment in maintenance hemodialysis patients.

关 键 词：维持性血液透析 认知功能障碍 影响因素 

分 类 号：R459.5[医药卫生—治疗学]