2型糖尿病肾病血液透析患者心理状况探讨

Psychological status in type 2 diabetic nephropathy patients following haemodialysis

目的探讨2型糖尿病肾病血液透析患者的心理状况及相关因素,为患者心理康复提供依据。方法糖尿病肾病患者30例,以及随机选取非糖尿病肾病患者30例。使用焦虑自评量表和抑郁自评表分别评估患者的情绪状况,并测定患者的营养状况、残余肾功能和透析的充分性等指标。结果糖尿病肾病血透组患者焦虑和抑郁检出率均高于非糖尿病肾病组(P<0.05);糖尿病肾病营养不良患者焦虑和抑郁评分均高于营养良好者(P<0.01)。血清白蛋白、标准化氮出现率相当蛋白、平均每日每公斤体质量的蛋白质摄入量、尿素清除指数和肌酐清除率等指标与糖尿病肾病血透组患者焦虑评分(P<0.05)及抑郁评分(P<0.05)呈明显负相关。而平均每日每公斤体质量的热量与焦虑评分、抑郁评分无明显相关性(P>0.05)。结论糖尿病肾病血透患者焦虑和抑郁症状的检出率较高,可能与营养不良有一定的关系,焦虑、抑郁的发生与性别、应激因素及病程有关。

Objective To investigate the psychological status in diabetic nephropathy（DN） patients and its relations with haemodialysis , so as to provide evidence to give psychological rehabilitation. Methods A total of 60 patients were entered into our study. And these 60 patients were divided into DN group （n= 30）and non DN group（n= 30）. The self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were used to evaluate the emotional status of the patients. Nutritional status, remaining kidney function and the sufficiency of dialysis were also observed. Results The anxiety and depression rates of DN patients were higher than those of non DN patients（P 〈 0. 05）. The scores of anxiety and depression in malnutrition patients was higher than those in good nutritious patients（P 〈 0. 01）. Serum albumin（ALB）, normalized protein equivalent of nitrogen appearance rate （nPNA）, daily protein input（DPI）, urea clearness index（ UCI） and ereatinine clearness rate（CCR）were negatively correlated with the scores of anxiety（P 〈 0. 05） and depression in DN patients（P 〈 0. 05）, while calories of body mass（kg per day）was not correlated with the scores of anxiety and depression（P〉0.05）. Conclusion The morbidity of anxiety and depression in DN patients following haemodialysis is higher, which is correlated with malnutrition. The anxiety and depression are related to sex, stress factors and duration of illness.