慢性肾脏病不同分期患者认知功能水平的研究

Cognitive function in patients with chronic kidney disease at different stages

目的探讨慢性肾脏病(chronickidneydisease,CKD)不同分期患者认知功能水平的变化。方法入选2010年5月至2012年4月在北京博爱医院肾内科就诊的CKD患者,根据基于肌酐的肾小球滤过率(GFR)评估公式估测的GFR(eGFR)水平将患者分为CKD1-2期组、CKD3-4期组、CKD5期组,其中CKD5期组又根据透析与否分为CKD5期非透析组、CKD5期透析组。应用中国修订韦氏成人智力量表(WAIS-RC)进行认知功能水平的评估。采用单因素方差分析法对CKD不同分期患者的认知功能水平进行比较。结果共入选103例CKD患者,包括CKD1-2期31例,平均年龄(54.77±12.70)岁;CKD3-4期25例,平均年龄(62.24±14.36)岁;CKD5期非透析组10例,平均年龄(60.03±12.10)岁;CKD5期透析组37例,平均年龄(65.00±14.41)岁。CKD1-2期组、CKD3-4期组、CKD5期非透析组、CKD5期透析组患者总智商评分分别为102.00±18.09、90.80±18.87、93.2±15.66、94.14±22.48(F值=1.69,P=0.17);言语智商评分分别为103.10±15.31、92.68±20.68、90.61±19.54、98.73±17.86(F值=2.13,P=0.10);操作量表评分分别为98.74±2.04、87.88±20.68、94.90±15.72、95.00±17.53(F值=1.25,P=0.30)。随着eGFR的下降,CKD不同分期患者的认知功能水平呈现部分下降的趋势,4组之间在总智商、语言智商、操作智商方面尚未达到统计学差异(P>0.05)。结论 CKD不同分期的患者,随着eGFR的下降,患者的认知功能有一定程度的下降趋势。

Objective To evaluate the cognitive function in patients with different stages of chronic kidney disease （CKD）. Methods Atotal of 103 CKD patients from Department ofNephrology, Beijing Boai Hospital, China Rehabilitation Research Center were enrolled in this study. They were divided into four groups according to eGFR： CKD 1-2 stages group, CKD 3-4 stages group, CKD 5 stage non-dialysis group, and CKD 5 stage dialysis group. Cognitive function was evaluated by the Wechsler Adult Intelligence Scale-Revised by China. Cognitive function in CKD patients at different stages was compared by using the statistical analysis of one-way ANOVA. Results In the 103 CKD patients, 31 patients were in the CKD 1-2 stages group with the mean age of 54.77 ± 12.70 years, 25 patients in the CKD 3-4 stages group with the mean age of 62.24± 14.36 years, 10 patients in the CKD 5 stage non-dialysis group with the mean age of 60.03± 12.10 years, and 37 patients in the CKD 5 stage dialysis group with the mean age of 65.00 ± 14.41 years. There was a tendency that the reduction of cognitive function was partially associated with the lowering of eGFR. No statistical differences were found in full scale intelligence quotient, verbal intelligence quotient, and performance intelligence quotient among the four groups （P 〉 0.05）. Conclusion In CKD patients at different stages, cognitive function may decrease in association with the decrease of eGFR