中国血液净化

›› 2009, Vol. 8 ›› Issue (1): 28-31.

• 论著 • 上一篇    下一篇

维持性血液透析患者抑郁症状及其相关因素分析

倪 丽 匡鼎伟 黄碧红 陈 靖 顾 勇   

  1. 复旦大学附属华山医院肾脏科-复旦大学肾脏病研究所
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-01-12 发布日期:2009-01-12

Analysis on depressive symptoms and the related factors in maintenance hemodialysis patients

NI Li, KUANG Ding-wei, HUANG Bi-hong, CHEN Jing, GU Yong   

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-01-12 Published:2009-01-12

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摘要： 【摘要】目的 调查维持性血液透析(maintenance hemodialysis, MHD)患者中抑郁症状发生情况并分析其相关因素，为提高患者生存质量提供依据。方法 采用横断面调查，应用Zung抑郁自评量表(SDS)对复旦大学附属华山医院血液净化中心64例MHD患者进行评估，将患者分为存在抑郁症状组和无抑郁症状组，同时收集患者的一般临床资料、社会背景资料及实验室检查结果，进行统计分析，探讨抑郁症状及其相关因素。结果 SDS的测定结果显示，MHD患者中抑郁症状的发生率为60.9%。抑郁症状组独身率、血清CRP水平明显高于无抑郁症状组(独身率：14/39 vs.3/25，P＜0.05；CRP(3.22±3.39)mg/L vs (2.58±2.81)mg/L，P＜0.05），而血红蛋白、血清白蛋白水平则显著偏低（血红蛋白：(101.0±18.7)g/L vs.(109.2±14.8)g/L，P＜0.05；白蛋白(38.7±3.6)g/L vs.(40.5±2.7)g/L，P＜0.05）。进一步进行多因素Logistic回归分析发现婚姻状况、血红蛋白水平是抑郁症状的主要相关因素，发生抑郁的概率方程Ln(P/(1－P))=6.611＋1.627 X1－0.061 X2。患者的年龄、性别、透析时间、文化程度、透析充分性及钙磷代谢在两组间无显著性差异。结论 MHD患者抑郁症状发生率较高，与婚姻状况、肾性贫血、慢性炎症及营养状态有关，其中婚姻状况、血红蛋白水平可能是重要的相关因素。

关键词: 抑郁症状, 血液透析, 相关因素

Abstract:

【Abstract】Objective We investigated the incidence of depression symptoms and the related factors in maintenance hemodialysis (MHD) patients, to understand the useful measures for the improvement of their life quality. Methods Sixty-four outpatients (male 24, female 40) with end-stage renal disease (ESRD) treated with MHD were recruited from the Dialysis Center of Huashan Hospital to participate in a cross-sectional study. Depression manifestations were assessed by Zung self-rating depression scale (SDS). If SDS score=50 points, the patient was thought as suffering from depression symptoms. Patients were divided into non-depression group (non-D group) and depression group (D group) according to the SDS score obtained. Their basic clinical information, demographic characteristics and laboratory parameters were also collected. Data were analyzed using the Statistical Package of SPSS 12.0. Results Based on the SDS, 39 cases (60.9%) were identified as having depression symptoms in this dialysis center. More patients with the marital status of single person and higher C-reactive protein were found in D group than in non-D group [14/39 vs. 3/25, P＜0.05 and (3.22±3.39)mg/L vs. (2.58±2.81)mg/L, P＜0.05, respectively]. Hemoglobin and serum albumin were lower in D group than in non-D group[(101.0±18.7)g/L vs. (109.2±14.8)g/L, P＜0.05 and (38.7±3.6)g/L vs. 40.5v2.7g/L, P＜0.05, respectively]. Multifactor logistic regression analysis revealed that marital status and hemoglobin were the main related factors. The regression equation was Ln (P/(1-P))=6.611+1.627 X1-0.061 X2. There were no significant differences in age, gender, hemodialysis period, educational level, hemodialysis adequacy and calcium-phosphate metabolism between the two groups. Conclusions Depression symptoms were frequently seen in MHD patients, and were related to marital status of single person, anemia, chronic inflammation condition and nutrition status. Marital status and hemoglobin level may be the important factors related to depression symptoms.

Key words: Hemodialysis, Related factors

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