摘要
目的探讨老年血液透析(HD)患者血清超敏C反应蛋白(hs-CRP)与认知功能损伤的关系。方法通过蒙特利尔认知量表筛查患者认知功能,将患者分为认知功能正常组及认知功能损伤组。同时收集患者临床资料,比较两组患者的相关指标并通过多因素Logistic回归方法分析认知功能损伤与血清hsCRP关系。结果 119例老年HD患者,平均年龄(72.6±11.9)岁,认知功能损伤者79例,认知功能损害患病率为66.4%。两组患者年龄、受教育程度、糖尿病史、血红蛋白、血清白蛋白及血清hs-CRP水平比较,差异有统计学意义(P<0.05);多因素Logistic回归显示,年龄、教育程度、糖尿病、血清hs-CRP水平及贫血是认知功能损伤的影响因素(P<0.05)。以血清hs-CRP为变量对HD患者认知损伤诊断效能的ROC曲线下面积为0.812(95%CI:0.732,0.892),判定其发生认知损伤血清hs-CRP临界值为9.75 mg/L,其敏感性为70.9%,特异性为82.5%。结论老年HD患者认知功能损伤不仅与年龄、教育程度、糖尿病史及贫血相关。高血清hs-CRP也是认知功能损伤发生的独立危险因素,该指标可能成为预测认知功能损伤的有效指标。
Objectives To investigate the relationship between cognitive impairment of elderly hemodialysis patients and serum hypersensitive C reactive protein (hs-CRP). Methods A cross-sectional study was performed in 119 hemodialysis patients to evaluate the cognitive function evaluated by Montreal Cognitive Assessment (MoCA) and serum hp-CRP level. A multi-logistic regression was performed to access the potential associated risk factor of cognitive impairments. Receiver operating characteristics (ROC) curve was also plotted to evaluate the diagnostic value of hs-CRP towards the cognitive impairment. Results 79 of 119 elderly hemodialysis patients aged from 60 to 86, whose MoCA scores were less than 26, and the prevalence of cognitive impairment was 66.4%.There were significantly older age, higher proportion of diabetes, lower education level, lower serum hemoglobin, albumin level and higher serum hs-CRP level in MCI groups (P < 0.05). Multi-logistic regression analysis showed that older age, lower educational status, diabetes, anemia, and the higher serum hs-CRP level were independently associated with cognitive impairment (P < 0.05). The area under curve of ROC analysis was 0.812 (95% CI (0.732, 0.892)), the cutoff point of serum hs-CRP under the maximum Youden index was 9.75 mg/L, and the sensitivity was 70.9% and the specificity was 82.5%. Conclusions Cognitive impairment is common in elderly hemodialysis patients. It might be associated with anemia, senior age, educational status and diabetics. High serum level of hs-CRP is also an independent risk factor for cognitive impairment, which may be an effective index for predicting cognitive impairment.
作者
张春霞
郭一丹
罗洋
Chun-xia Zhang;Yi-dan Guo;Yang Luo(Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038 China)
出处
《中国现代医学杂志》
CAS
2019年第16期85-89,共5页
China Journal of Modern Medicine
基金
北京市科学技术委员会国家重大研发匹配基金(No:Z161100002616005)
关键词
肾病
肾透析
认知障碍
kidney diseases
renal dialysis
cognitive dysfunction
