维持性血液透析患者认知功能障碍的多因素分析  

Multivariate analysis of cognitive dysfunction in maintenance hemodialysis patients

作　　者：白亚飞[1] 陈汝满 徐明芝[1] 安娜[1] 王春莉 曾欣[1] 黎吉锋 魏倩 李洪[1] Bai Yafei;Chen Ruman;Xu Mingzhi;An Na;Wang Chunli;Zeng Xin;Li Jifeng;Wei Qian;Li Hong(Department of Blood Purification,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院(海南医科大学附属海南医院)血液净化中心,海口570311

出　　处：《中华肾脏病杂志》2025年第1期49-53,共5页Chinese Journal of Nephrology

摘　　要：本研究为单中心横断面调查研究,拟通过探索维持性血液透析(maintenance hemodialysis,MHD)患者认知功能障碍的危险因素,为改善患者预后提供依据。选择2023年6月1日至30日海南省人民医院血液净化中心MHD患者作为研究对象,使用简易智能精神状态检查量表对其进行评分,并采用Logistic回归模型分析MHD患者认知障碍的危险因素。共纳入278例患者,其中69例(24.8%)存在认知功能障碍。多因素Logistic回归分析提示脑血管疾病史(OR=3.109,95%CI 1.310~7.378,P=0.010)、高龄(OR=1.077,95%CI 1.040~1.115,P<0.001)、低透析频率(OR=0.270,95%CI 0.120~0.606,P=0.001)、低学历(以大专及大学为对照组,小学组OR=26.960,95%CI 7.519~96.673,P<0.001;初中及中专组OR=4.264,95%CI 1.330~13.650,P=0.015;高中组OR=9.554,95%CI 2.861~31.904,P<0.001)、高β2微球蛋白(OR=1.609,95%CI 1.044~2.480,P=0.031)及高C反应蛋白/白蛋白比值(>0.267,OR=2.672,95%CI 1.226~5.826,P=0.013)是MHD患者认知功能障碍发生的独立相关因素。This study was a single-center cross-sectional investigation aimed at identifying risk factors for cognitive dysfunction in patients undergoing maintenance hemodialysis(MHD),with the goal of providing a basis for improving patient prognosis.Patients receiving MHD in the Blood Purification Center of Hainan Provincial People's Hospital from June 1 to June 30,2023,were enrolled.Cognitive function was assessed using the Mini-Mental State Examination(MMSE),and potential risk factors for cognitive impairment were analyzed by using Logistic regression.A total of 278 patients were included,69 patients(24.8%)of whom had cognitive impairment.Multivariate Logistic regression analysis indicated that the history of cerebrovascular disease(OR=3.109,95%CI 1.310-7.378,P=0.010),old age(OR=1.077,95%CI 1.040-1.115,P<0.001),low dialysis frequency(OR=0.270,95%CI 0.120-0.606,P=0.001),low academic qualification(using college/university as the control group:primary school group OR=26.960,95%CI 7.519-96.673,P<0.001;Junior high school/technical secondary school group OR=4.264,95%CI 1.330-13.650,P=0.015;High school group OR=9.554,95%CI 2.861-31.904,P<0.001),highβ2-microglobulin(OR=1.609,95%CI 1.044-2.480,P=0.031)and high C-reactive protein/albumin(OR=2.672,95%CI 1.226-5.826,P=0.013)were independent risk factors for cognitive impairment in MHD patients.

关 键 词：肾功能不全 慢性 肾透析 危险因素 认知功能障碍 

分 类 号：R47[医药卫生—护理学]