60例维持性血液透析患者抑郁障碍调查及相关因素分析

The analysis of the related factors of depression in maintenance hemodialysis patients

目的探讨维持性血液透析患者产生抑郁障碍的机率、相关因素及药物干预的效果。方法应用抑郁的诊断标准及抑郁自评量表(SDS)对60例无精神病病史的维持性血液透析患者进行诊断及评分,根据评分结果将患者分成抑郁组和非抑郁组。比较两组患者性别、年龄、文化程度、透析时间、就业率、医疗付费方式、营养状态和顺应性的差异。同时,对有抑郁障碍的患者予百忧解抗抑郁治疗,观察抗抑郁治疗的疗效。结果18.3%的血透患者有抑郁障碍;两组患者的年龄、性别、文化程度、透析时间比较均无显著性差异;抑郁组中不顺应者、自费率、营养不良发生率、糖尿病肾病(DN)的比率均显著高于非抑郁组,而就业率却低于非抑郁组;百忧解治疗后患者的睡眠障碍、对日常生活丧失兴趣,无愉快感及自责和内疚感等三项症状改善较为明显。结论血液透析患者产生抑郁障碍的机率较高;血液透析患者抑郁障碍与患者的营养不良、顺应性下降、自费、低就业率及糖尿病等因素有关;抗抑郁药物治疗维持性血液透析患者的抑郁障碍有一定疗效。

Objective To investigate the incidence and possible reasons of depression in maintenance hemodialysis patients. Methods 60 maintenance hemodialysis patients without psychotic disorder were enrolled. Patients were divided into two groups （ depression group and normal group） by the diagnositic standard of depression and self-rating depression scale （SDS）. The nutritional status .sex.age.education and compliance between the two groups were compaired. Results 18.3% patients were suffered from depression ;There were no differences in sex, dialysis time, age and education between two groups ;The incidence of mal-nutritional status, bad compliance, DN and self-expenses were higher than those in normal group, while the rate of employment was lower than that in normal group. Conclusion Depression was common in maintenance hemodialysis patients;Depression was related with malnutrition, noncompliance, unemployment, DN and self-expenses.