维持性血液透析患者抑郁症状及其相关因素研究.docVIP

维持性血液透析患者抑郁症状及其相关因素研究[摘要] 目的 调查维持性血液透析（maintenance hemodialysis，MHD）患者抑郁症状的发生情况并分析其影响因素，为制定治疗策略、提高患者生存质量提供依据。 方法 采用横断面研究，使用贝克抑郁问卷（Beck depression inventory，BDI）对80例进行MHD治疗的门诊患者进行抑郁评估，同时收集患者的社会人口学资料、临床和实验室指标进行统计分析，最终77例患者完成研究。对研究对象中37例连续使用同一种透析器进行血液透析3个月及以上的患者按透析膜材料分为聚砜膜组（p组）和醋酸纤维素膜组（c组），并作分组分析。 结果 根据BDI评分，MHD患者抑郁发生率为58.4%。透析器分组研究发现c组患者（抑郁发生率为83.3%）较p组患者（抑郁发生率为36.8%）发生抑郁的可能性要高（P 0.01）。Spearman秩相关分析亦确认BDI值与透析膜材料相关，并与血清IL-6水平呈正相关（P 0.05）。进一步作多因素Logistic回归分析，发现透析膜是抑郁的主要影响因素（OR = 0.083，P 0.05）。 结论 MHD患者抑郁发生率较高，且与患者血清IL-6水平有关，聚砜膜透析器可能对MHD患者抑郁发生起保护作用。 [关键词] 抑郁；维持性血液透析；相关因素 [中图分类号] R749 [文献标识码] A [文章编号] 1673-7210（2012）08（a）-0041-03 Correlates of symptoms of depression in maintenance hemodialysis patients ZHANG Jingyi1 FENG Min2 KONG Li1 XU Anping2 1.Department of Nephrology, Guangzhou Xinhai Hospital, Guangdong Province, Guangzhou 510300, China; 2.Department of Nephrology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong Province, Guangzhou 510120, China [Abstract] Objective To investigate the incidence of depression symptoms and the relevant factors in maintenance hemodialysis (MHD) patients, and to provide the basis for the development of treatment strategies and the improvement of their life quality. Methods A cross-sectional study was conducted. 80 patients treated with MHD were asked to filled out the BDI self-reported rating scales. MHD patients′ socio-demographic characteristics, clinical information and laboratory parameters were also collected, finally 77 patients completed this study. 37 MHD patients who had used the same type of dialyzer no less than 3 months were picked out and divided into two groups: cellulose derivative group (group c) and polysulfone group (group p). Then further analysis would be performed. Results Based on the BDI, the prevalence of depression in MHD patients was 58.4%. Compared with nondepressed patients, depressed patients were more likely to use cellulose derivative dialyzers, depression affected 83.3% o