于立丽;陈文;
YU Lili;CHEN Wen;Department of Nephrology, Second People's Hospital of Hainan Province;Department of Nephrology, Second Affiliated Hospital of Hainan Medical College;

• 1:海南省第二人民医院肾病学科
• 2:海南省医学院附属第二医院肾内科

摘要(Abstract)：

目的:探讨老年慢性肾衰竭患者血液透析维持治疗中抑郁症发病状态与营养不良-炎症-动脉粥样硬化综合征(MIA)的相关性。方法:92例行血液透析的肾功能不全患者作为研究对象,其中44例合并抑郁患者作为观察组、48例单纯肾功能不全患者作为对照组,采用血清白蛋白水平评估两组患者营养情况、外周血白细胞介素-6(IL-6)水平评估患者体内炎症状态、平均颈总动脉内膜厚度(IMT)评价患者心血管疾病发生情况;采用Pearson相关分析观察组抑郁自评量表(SDS)评分与患者年龄、透析龄、IMT、外周血IL-6及血清白蛋白水平的相关性。结果:观察组患者IMT及外周血IL-6显著高于对照组,血清白蛋白水平显著低于对照组(P<0.01);Pearson相关分析结果显示,合并抑郁症患者SDS评分与外周血IL-6及IMT呈正相关(r=0.634、0.469,P<0.01),与血清白蛋白显著负相关(r=-0.669,P<0.01);SDS评分与患者年龄、透析龄等变量无相关性(P>0.05)。结论:血液透析的老年慢性肾功能衰竭并发抑郁症患者与发生MIA综合征呈正相关。
Objective: To investigate the incidence of depression in maintenance hemodialysis patients with chronic renal failure and its relationship with MIA syndrome. Methods: The data of patients with renal insufficiency undergoing hemodialysis from April 2015 to April 2017 in the the Second Affiliated Hospital Of Hainan Medical University.The depressive state of patients was evaluated according to the depression self-rating scale. The nutritional status of patients was assessed by subjective global assessment(SGA) and peripheral blood albumin level. The levels of IL-6 in peripheral blood were measured to evaluate the inflammatory status in the patients. The average carotid artery intima-media thickness(IMT) was measured to assess the patient's cardiovascular status. The patients were divided into depression group and non-depression group according to their depression score. The nutritional status, IL-6 level and IMT in peripheral blood were compared between the two groups. Pearson correlation test was used to analyze the relation between SDS scores in observation group and various components of SGA, IMT, IL-6 and age, and to explore the correlation between depression status and MIA syndrome. Results: A total of 92 patients with hemodialysis were included in the study. After screening by SDS, 44 patients with depression were classified as observation group and 48 patients with non-depression as control group. The observation group and control group were significantly different in sex, age and dialysis age There was no significant difference between the two groups(P>0.05). The IMT, IL-6 and albumin levels in both groups were statistically significant(P<0.01). Correlation analysis between SDS score of depression group and age, dialysis age, IMT value, IL-6 and albumin level showed that SDS score was positively correlated with IL-6 and IMT, Significantly negative correlation with serum albumin, the difference was statistically significant(P<0.05). SDS scores were not found and age, dialysis age and other variables(P>0.05).Conclusion: The ratio of depression and MIA syndrome is high in hemodialysis patients, and there is a close relationship between depression and IL-6, IMT and hypoproteinemia.

关键词(KeyWords)： 血液透析;终末期肾脏病;抑郁;精神障碍;营养不良-炎症-动脉粥样硬化综合征
hemodialysis;end-stage renal disease;depression;mental disorder;malnutrition-inflammation-atherosclerosis syndrome

Abstract:

Keywords:

基金项目(Foundation): 海南省科学技术厅项目(ZDXM2015085)

作者(Author): 于立丽;陈文;
YU Lili;CHEN Wen;Department of Nephrology, Second People's Hospital of Hainan Province;Department of Nephrology, Second Affiliated Hospital of Hainan Medical College;

Email:

DOI: 10.19367/j.cnki.1000-2707.2019.05.020

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