维持性血液透析患者抑郁障碍调查及相关因素分析

The investigation of depression and its related factors in maintenance hemodialysis patients

目的调查维持性血液透析患者抑郁障碍发生情况并进行相关因素分析。方法应用汉密尔顿抑郁量表横断面调查规律性血液透析患者180例,将患者分为抑郁障碍组和非抑郁障碍组,同时收集患者的基本资料及实验室数据。结果 180例维持性血液透析患者中抑郁障碍的患病率为56.7%,抑郁障碍组的年龄、脂蛋白a、空腹血糖值、EPO/HCT比值显著高于非抑郁障碍组(t值分别为-3.343、-3.098、-2.826、-2.990,P均<0.05),而血清白蛋白、前白蛋白、肌酐、尿酸、血红蛋白、红细胞压积低于非抑郁障碍组(t值分别为3.968、2.611、2.998、2.324、1.990、1.981,P均<0.05)。多元回归分析发现女性、脂蛋白a升高、空腹血糖升高为维持性血液透析患者合并抑郁障碍的危险因素。结论维持性血液透析患者抑郁障碍的患病率高;合并抑郁障碍的患者营养状态差,更易发生贫血;注意纠正患者的糖脂代谢紊乱。

Objective We investigated the prevalence of depression and its related factors in maintenance hemodialysis patients.Methods A total of 180 cases of maintenance hemodialysis(MHD) were divided into depression group and non-depression group according to the scores from Hamilton depression scale.Their basic information and laboratory data were collected at the same time.Results The prevalence of depression was 56.7% in the 180 MHD patients.Age,lipoprotein A,fasting blood glucose,and EPO/HCT ratio were significantly higher in the depression group than in the non-depression group(t =-3.343,-3.098,-2.826 and-2.990,respectively;P<0.05).Serum albumin,pre-albumin,creatinine,uric acid,hemoglobin and hematocrit were lower in the depression group than in the non-depression group(t =3.968,2.611,2.998,2.324,1.990 and 1.981,respectively;P<0.05).Multivariate regression analysis revealed that female gender,high lipoprotein A and high fasting blood glucose were the risk factors for MHD patients with depression.Conclusions The prevalence of depression was relatively high in MHD patients.Malnutrition and anemia were frequently seen in MHD patients with depression,and management to their disturbances in carbohydrate and lipid metabolism is required.