摘要
目的分析老年维持性血液透析患者抑郁状态的患病情况,并探讨其与营养不良-炎症-动脉粥样硬化综合征(malnutrition-inflammation-atherosclerosis syndrome,MIA)的相关性。方法选取2019年10月—2021年1月在福建医科大学附属厦门弘爱医院接受维持性血液透析治疗的老年透析患者67例作为研究对象,采用抑郁自评量表(self-rating depression scale,SDS)评价老年维持性血液透析患者抑郁状态,根据老年维持性血液透析患者的抑郁状态分为抑郁组和非抑郁组。收集老年维持性血液透析患者的一般情况,采用改良主观全面营养评价法及血清白蛋白(albumin,ALB)水平评估两组老年维持性血液透析患者营养情况,以外周静脉血白细胞介素-6(interleukin-6,IL-6)及C反应蛋白(C-reactive protein,CRP)水平评估老年维持性血液透析患者的微炎症状态,而老年维持性血液患者动脉粥样硬化情况则以平均颈总动脉内膜中层厚度(intima-media-thickness,IMT)来评价。比较两组患者的一般情况及营养状态、外周血IL-6、CRP水平及IMT。运用Pearson法分析SDS评分分别与年龄、性别、透析龄、营养不良评分、肌酐、尿素氮、IMT值、ALB、IL-6、CRP等指标的相关性。同时以老年维持性血液透析患者SDS评分为因变量,以CRP、ALB及IMT值为自变量进行多元逐步回归分析。结果研究共纳入患者67例,其中31例存在抑郁症状态,抑郁状态患病率为46.27%。抑郁组患者IMT、营养不良评分、CRP及IL-6高于非抑郁组,而血清ALB水平低于非抑郁组,差异有统计学意义(P<0.05)。经Pearson相关分析,抑郁组患者SDS评分与IL-6、CRP、营养不良评分及IMT成正相关,与血清ALB成负相关。多元逐步回归分析显示,CRP、ALB及IMT值均为老年维持性血液透析发生抑郁症的影响因素,差异有统计学意义(P<0.05),回归方程=45.961+0.461×CRP+26.43×IMT-0.792×ALB。结论老年维持性血液透析患者抑郁状态患
Objective To analyze the incidence of depression in elderly maintenance hemodialysis patients and to determine the correlation with malnutrition-inflammatory-arteriosclerosis syndrome(MIA).Methods Sixty-seven elderly dialysis patients were selected as research subjects from Xiamen Humanity Hospital Affiliated to Fujian Medical University between October 2019 and January 2021.The self-rating depression scale(SDS)was used to evaluate the depression status of elderly maintenance hemodialysis patients.The elderly maintenance hemodialysis patients were divided into depression and non-depression groups based on the depression status.General information of the elderly maintenance hemodialysis patients was obtained.The nutritional status of elderly maintenance hemodialysis patients in the two groups was evaluated using the improved subjective comprehensive nutritional evaluation method and the serum albumin(ALB)level was measured.The micro-inflammatory status of elderly maintenance hemodialysis patients was evaluated based on the levels of interleukin-6(IL-6)and C-reactive protein(CRP)in peripheral venous blood.Atherosclerosis in elderly maintenance hemodialysis patients was evaluated based on the mean common carotid artery intimal media thickness(IMT).The general situation,nutritional status,peripheral blood IL-6,CRP,and IMT of the two groups were compared.The Pearson method was used to analyze the correlation between the SDS score and age,gender,dialysis age,malnutrition score,creatinine,urea nitrogen,IMT value,ALB,IL-6,and CRP.Multiple stepwise regression analysis was performed with the SDS score of elderly maintenance hemodialysis patients as dependent variables and CRP,while protein and IMT values were independent variables.Results Sixty-seven patients were included in the study,of which 31 had depression;the prevalence of depression was 46.27%.The IMT,malnutrition score,CRP,and IL-6 of the depression group were higher than the non-depression group,while the serum ALB level was lower than the non-depression group(P<
作者
华锦程
张燕林
许树根
廖铭铭
HUA Jin-cheng;ZHANG Yan-lin;XU Shu-gen;LIAO Ming-ming(Department of Nephrology,Xiamen Humanity Hospital Affiliated to Fujian Medical University,Fujian 361000,China)
出处
《慢性病学杂志》
2022年第11期1661-1664,1668,共5页
Chronic Pathematology Journal
关键词
维持性血液透析
抑郁
营养不良
炎症
动脉粥样硬化
Maintenance hemodialysis
Depression
Malnutrition
Inflammation
Atherosclerosis
