血液透析患者基于事件和时间的前瞻性记忆损害研究  

Prospective memory impairment based on events and time in hemodialysis patients

作　　者：何睦 朱智峰 黄杰 刘春学 He Mu;Zhu Zhifeng;Huang Jie;Liu Chunxue(Department of Hemodialysis,Nantong Affiliated Hospital of Nanjing University of Chinese Medicine,Nantong 226000,China;Department of Nephrology,Nantong Affliated Hospital of Nanjing University of Chinese Medicine,Nantong 226000,China;Department of Critical Care Medicine,Nantong Affiliated Hospital of Nanjing University of Chinese Medicine,Nantong 226000,China)

机构地区：[1]南京中医药大学南通附属医院(南通市中医院)血透室,南通226000 [2]南京中医药大学南通附属医院(南通市中医院)肾内科,南通226000 [3]南京中医药大学南通附属医院(南通市中医院)危重症医学科,南通226000

出　　处：《国际泌尿系统杂志》2024年第3期398-403,共6页International Journal of Urology and Nephrology

基　　金：江苏省卫生健康委2020年度医学科研立项项目(H2020046)。

摘　　要：目的:探讨血液透析(HD)患者基于事件和时间的前瞻性记忆(PM)损害的临床特征。方法:前瞻性纳入2019年4月至2021年4月于本院行规律性HD的98例患者为观察组,同期选择年龄和性别相匹配的80例健康者为对照组。采用简易精神状态检查(MMSE)、数字广度测试(DST)、口语流利性测试(VFT)、Rey听觉词语学习测验(RAVLT)、Stroop色词测验(SCWT)、基于事件PM(EBPM)和基于时间PM(TBPM)进行多维度评价患者的认知功能。结果:观察组的MMSE、RAVLT(总回忆和延迟回忆)、VFT(水果)评分显著低于对照组,而SCWT(阅读、颜色命名、干扰和抑制/转换)耗时、SCWT(颜色命名和抑制/转换)错误数目显著高于对照组,差异均有统计学意义(均P<0.05)。观察组的EBPM(前瞻性和回顾性记忆)评分显著低于对照组,TBPM(前瞻性和回顾性记忆)评分以及时钟检查反应数目也显著低于对照组,差异均有统计学意义(均P<0.05)。Pearson检验结果显示,EBPM评分与RAVLT(总回忆)和VFT(水果)评分呈正相关,与SCWT(阅读和颜色命名)耗时呈负相关(均P<0.05);TBPM评分与RAVLT(延迟回忆)和VFT(水果)评分呈正相关(均P<0.05)。结论:HD患者的EBPM和TBPM损害可能是早期认知功能障碍的重要临床特征,对EBPM和TBPM的正确诊断有助于预防HD患者的认知功能障碍,对改善患者的生存预后具有重要意义。Objective To investigate the clinical characteristics of event and time-based prospective memory(PM)impairment in hemodialysis(HD)patients.Methods A total of 98 patients with regular HD into our hospital from April 2019 to April 2021 were prospectively included as the observation group,and 80 healthy subjects matched with age and sex were selected as the control group.The mini-mental state examination(MMSE),digit span test(DST),oral fluency test(VFT),Rey auditory oral learning test(RAVLT),Stroop color word interference test(SCWT),event-based PM(EBPM)and time-based PM(TBPM)were used to evaluate cognitive function.Results The MMSE,RAVLT total recall,delayed recall and VFT(fruit)scores in the observation group were significantly lower than those in the control group,while the SCWT(reading,color naming,interference and inhibition/switching)time,SCWT(color naming and inhibition/switching)the number of errors were significantly higher than those in the control group,the differences were statistically significant(all P<0.05).The prospective and retrospective memory scores of EBPM in the observation group were significantly lower than those in the control group,and the prospective and retrospective memory scores of TBPM and the number of clock checking responses were also significantly lower than those in the control group,the differences were statistically significant(all P<0.05).Pearson test showed that EBPM score was positively correlated with RAVLT total recall and VFT(fruit)score,negatively correlated with SCWT reading and color naming time(all P<0.05).TBPM score was positively correlated with RAVLT delayed recall and VFT(fruit)score(all P<0.05).Conclusions The damage of EBPM and TBPM in HD patients may be important clinical features of early cognitive dysfunction.The correct diagnosis of EBPM and TBPM is helpful to prevent cognitive dysfunction in HD patients and improve the prognosis of patients.

关 键 词：肾透析 认知功能障碍 前瞻性记忆 

分 类 号：R692.5[医药卫生—泌尿科学]