非血管性因素对维持性血液透析病人认知功能的影响

Influence of non-vascular factors on cognitive function of maintenance hemodialysis patients

[目的]探讨血液透析和慢性肾脏病相关因素对慢性肾衰竭血液透析病人认知功能的影响,为临床护理工作提供理论依据。[方法]按要求选取40例慢性肾衰竭血液透析病人和40例肾脏功能正常的健康人群作为研究对象,两组采用中文版蒙特利尔认知评估量表(MoCA)对其认知功能进行评估,比较两组认知功能水平和认知功能障碍的发生率,探讨影响血液透析病人认知功能的因素。[结果]血液透析病人认知功能障碍的发生率(75%)高于健康人群(50%,P<0.05);除命名和语言外,血液透析病人MoCA的其他项目得分均明显低于健康人群(P<0.05);年龄、血红蛋白水平对血液透析病人认知功能有影响。[结论]透析状况良好、无脑卒中及痴呆病史的血液透析病人认知功能障碍的发生率高于无肾脏疾病的健康人群,认知功能障碍在血液透析病人中的高发病率并不能完全归咎于传统的血管性危险因素,血液透析和慢性肾脏病相关因素可能与早期的认知功能损害有关。

Objective：To probe into influence of hemodialysis and relat- ed factors of chronic kidney disease on cognitive function of chronic kidney failure patients undergoing hemodialysis, so as to provide theo- retical evidences for clinical nursing work. Methods：A total of 40 chro- nic renal failure patients undergoing hemodialysis and another 40 healthy people with normal renal function were selected as study sub- jects,the cognitive function of both group patients was evaluated by u- sing Chinese version of MoCA, then to compare level of cognitive func- tion and the incidence of cognitive dysfunction and to probe into influ- encing factors of cognitive function of hemodialysis patients. Results= The incidence of cognitive dysfunction among hemodialysis patients （75 ~） was higher than that of healthy population （50 %, P^0.05）. Except naming and language,scores of other items in MoCA of hemo- dialysis patients were significantly lower than that of healthy popula- tion （P^0.05）. Age and hemoglobin level affected the cognitive func- tion of patients undergoing hemodialysis. Conclusion=The incidence of cognitive dysfunction in hemodialysis patients without a history of stroke and dementia is higher than that of healthy people without kid- ney disease. The high incidence of cognitive dysfunction in hemodialy- sis patients can not be attributed solely to the traditional vascular risk factors,blood dialysis and chronic kidney disease - related factors may be associated with early cognitive impairment.