摘要
目的:探讨终末期肾病患者抑郁状态与炎症和营养不良的关系。方法:采用汉密尔顿抑郁量表(HAMD)、超敏C反应蛋白(hs-CRP)和改良主观全面营养评价法(MSGAN)对63例终末期肾病血透患者分别进行抑郁状态、炎症和营养不良的评估,同时测定血清白蛋白(Alb)、前白蛋白(PA)、血红蛋白(Hb)、铁蛋白(SF)、肌酐(SCr)、尿素氮(BUN)等生化指标。根据HAMD评分将患者分为2组,HAMD评分≥17分为抑郁组,HAMD评分<17分为对照组,分别进行炎症和营养不良的评估。结果:抑郁组28例(44.44%),hs-CRP、营养不良评分(MS)明显高于对照组(P<0.01),血清Alb、PA、SF、Hb明显低于对照组(P<0.01或P<0.05),而BUN、SCr2组差异无统计学意义(P>0.05)。Pearson相关分析显示HAMD评分与年龄、糖尿病、hs-CRP和MS值呈明显正相关(P<0.05),与Alb、PA、SF、Hb和体质量指数呈负相关(P<0.05),而与性别、透析时间、BUN、SCr无明显相关(P>0.05)。结论:终末期肾病患者抑郁状态与炎症和营养不良密切相关,对于伴有hs-CRP增高的营养不良患者在排除潜在的躯体疾患后应重视对其抑郁状态的评估。
Objective： To investigate the relations of depression, inflammation and malnutrition in end-stage renal dis ease （ESRD）. Methods： Sixty-three patients with ESRD, who were on maintenance hemodialysis （HD）, were evaluated the depression using Hamilton Depression scale（HAMD）. The high sensitivity C-reactive protein（hs-CRP）, modified quantitative subjective global assessment of nutrition（MSGAN） and the biochemical parameters including serum albumin（Alb）, prealbumin （PA）, hemoglobin （Hb）, serum ferritin（SF）, crestinine（SCr） and urea nitrogen （BUN） were measured in ESRD patients. The patients were divided into depression group （HAMD scale ≥ 17） and control group （HAMD scale 〈17） according to the HAMD scale to compare with the level of hs-CRP, malnutrition score（MS） and some other biochemical parameters. Results： Twenty-eight patients （44.44%） had HAMD scale higher than or equal to 17, which is recommended for the diagnosis of depression. The mean values of hs-CRP and MS in the depression group were significantly greater than those in control group （P 〈 0.01）. The levels of serum Alb, PA, Hb and SF were significantly lower than those in control group （P 〈 0.01）. There were no significant differences in serum BUN and SCr in two groups （P 〉 0.05）. The HAMD scale showed a significant positive correlation with age, diabetics, hs-CRP and MS （P 〈 0.05）, but a significantly negative correlation with the serum Alb, PA, SF, Hb and body mass index （BMI） （P 〈 0.05）. Correlation analysis revealed no relationship between HAMD scale and gender, duration of HD, serum BUN and SCr （P 〉 0.05）. Conclusion： Depression is related closely to inflammation and malnutrition in ESRD. Malnutritional patients with higher serum hs-CRP in ESRD should be evaluated for depression after potential somatic causes have been eliminated.
出处
《天津医药》
CAS
北大核心
2007年第2期93-95,共3页
Tianjin Medical Journal
关键词
抑郁
炎症
营养不良
肾疾病
肾透析
depression
inflammation
malnutrition
kidney disease
renal dialysis
