维持性血液透析患者焦虑症状及其相关因素分析

Analyses of anxiety symptoms and their correlated factors in maintenance hemodialysis patients

目的调查维持性血液透析(maintenance hemodialysis,MHD)患者焦虑症状的发生情况并分析其影响因素,为制定治疗策略、提高患者生存质量提供依据。方法采用横断面研究,使用焦虑自评量表(self-rating anxiety scale,SAS)分别对77名进行MHD治疗的门诊患者、75名慢性肾脏病(chronic kidney disease,CKD)门诊患者及80名健康成人进行评估。同时收集MHD患者的社会人口学资料、临床和实验室指标进行统计分析,探讨MHD患者焦虑发生的影响因素。结果根据SAS评分:MHD患者焦虑发生率为36.4%,CKD患者焦虑发生率为38.7%,2组无统计学有差异(P>0.05);健康对照组焦虑发生率为6.3%,与前2组有统计学意义(P<0.001)。焦虑分组研究中发现年长或文化程度较低的MHD患者更容易发生焦虑(P<0.05);Spearman秩相关分析中亦进一步确认SAS值与年龄呈显著正相关,与文化程度呈显著负相关(P<0.05),而与其余临床和实验室指标无显著相关性。进一步作多因素Logistic回归分析,发现年龄是焦虑发生的主要影响因素,OR值为1.08(P<0.05)。结论 MHD患者焦虑发生率较高,与年龄和文化程度有关,且年龄可能是重要的影响因素。

Objectives We investigated the prevalence of anxiety symptoms and their relevant factors in maintenance hemodialysis(MHD) patients,to provide the bases for the development of treatment strategies and the improvement of their life quality.Methods A cross-sectional study was conducted.77 outpatients treated with MHD,75 outpatients with chronic kidney disease(CKD),and 80 healthy adults were included in this study.They were asked to fill out the SAS self-reported rating scales.MHD patients'socio-demographic characteristics,clinical information,and laboratory parameters were also collected.Data were analyzed using SPSS version 13.0 software.Results Based on SAS scores,the prevalence of anxiety in MHD patients(36.4%) and in CKD patients(38.7%) were significantly higher compared to the control group(6.3%;P<0.001).But there were no significant differences between the MHD group and the CKD group(P>0.05).In the MHD group,older or lower educated patients seemed more likely to have anxiety symptoms(P<0.05).From univariate analysis,SAS score correlated positively with age,and negatively with educational level(P<0.05).From logistic regression analysis,only age correlated with anxiety.The odds ratio was 1.08(P<0.05).Conclusions Anxiety symptoms were much common in MHD patients.Older or lower educated MHD patients were more likely to have anxiety symptoms.Age would be the important factor relating to anxiety symptoms.