49例血透患者认知功能的临床研究

Clinical Study of Cognitive Dysfunction in 49 Maintenance Hemodialysis Patients

目的 探讨维持性血透患者的认知功能及其可能的影响因素。方法 应用MMSE对4 9例行门诊血透的患者进行认知功能评估,与正常人群进行对照研究。结果 血透治疗前14 .3% (7/ 4 9)的患者存在轻度认知功能障碍(MMSE评分18～2 3分) ,6 .12 % (3/ 4 9)的患者存在中至重度的认知功能障碍(MMSE评分0～17分) ,治疗后其认知障碍有改善但仍低于正常人(P <0 .0 1)。多元逐步回归分析显示,MMSE分值与合并症数目增多,血红蛋白含量下降及血清白蛋白降低显著相关。结论 血透患者的认知功能减退可能与其合并症数目、血红蛋白含量、白蛋白等因素相关。

Objective To investigate cognitive dysfunction and its correlated factors in maintenance hemodialysis patients. Methods We administered the Mini Mental State Examination (MMSE) for assessing cognitive function to 49 patients undergone outpatient hemodialysis and compared with that the normal controls. Results We found that 14.3% (7/49) of subjects had mild mental impairment (MMSE 18～23) and that 6.12% (13/49) had moderate to severe mental impairment (MMSE 0～17) before dialysis. Cognitive capacity in hemodialysis patients was still lower than that in the controls after dialysis. Multivariant stepwise regression analysis showed that MMSE score was significantly associated with increased number of co-morbid conditions, lower hemoglobin concentration and Albumin. Conclusion Cognitive capacity decline in hemodialysis patients is associated with number of co-morbid conditions, lower hemoglobin concentration and Albumin etc.