血液透析和灌流对尿毒症患者认知功能的影响

Effect of hemodialysis and hemoperfusion on cognitive function in uremic patients

目的探讨血液透析和灌流对尿毒症患者认知功能的影响。方法将66例尿毒症患者纳入研究,随机分为综合组、对照组各33例,疗程结束后进行相关实验室指标以及采用《基本认知能力测验》软件进行检测,治疗前后均采用QLQ-C30进行生活质量测评1次。结果与对照组比较,治疗后综合组在PTH、β2-MG、CRP均下降明显,两组比较差异具有统计学意义(P<0.05);而在Scr下降方面,综合组明显优于对照组(P<0.01)。与综合组比较,对照组在心算、数字工作记忆方面得分较低,差异具有显著性意义(P<0.05)。两组治疗后,躯体、角色、情感、认知、社会功能和整体健康状况评分的均值显著增加,且差异均有显著性(P<0.05或P<0.01),综合组较对照组改善更明显(P均<0.05);两组治疗后乏力、食欲减退、呼吸困难、咳嗽、疼痛等症状评分较治疗前降低,差异有显著性(P<0.05或P<0.01),其中综合组在改善乏力、食欲减退方面较对照组更具优势(P均<0.05)。结论血液透析和血液灌流结合治疗能够改善尿毒症患者的认知功能障碍,提高生活质量。

Objective To observe cognition function in uremic patients and the changes of cognition function after hemodialysis and hemoperfusion associated with hemodialysis.Methods Totally 66 patients were randomly divided into hemodialysis group and hemoperfusion associated with hemodialysis group.Treatment related laboratory index after the basic and using cognitive ability test software testing,before and after treatment all use life QLQ-C30 treatment evaluation.Results Compared with maintaining control,after treatment in PTH,beta 2-MG,CRP decreased obviously,two groups of comparisons are statistically significant difference（P〈0.05）.And in Scr,maintaining dropped significantly better than that of the control group（P〈0.01）.In comparison with maintaining control arithmetic,digital,working memory,low scoring with significant difference meaning（P〈0.05）.Two groups after treatment,body,roles,emotional,cognitive and social functions and overall health score significantly increased,and the average difference were significant（P〈0.05 or P〈0.01）,maintaining a control group were more obvious improvement（P〈0.05）.The two groups after treating fatigue,anorexia,difficulty breathing,cough,pain,the symptom score is reduced,before treatment group（P〈0.05 or P〈0.01）,among them,in improving fatigue,anorexia aspects more advantages than control group（P〈0.05）.Conclusions Cognition function was abnormal in most uremic patients.Blood purification,especially hemoperfusion associated with hemodialysis,improves cognition function in these patients.