维持性血液透析患者抑郁与认知功能的关系

The relationship between depression and cognitive function in maintenance hemodialysis patients

目的探讨维持性血液透析(Maintenance Hemodialysis,MHD)患者抑郁和认知功能之间的关系。方法使用抑郁自评量表对117名MHD患者进行抑郁症状评估,根据评估结果将患者分为抑郁组和非抑郁组。对两组被试均施以认知功能神经心理学测验,包括蒙特利尔认知评估量表、Stroop测验、连线测验A、B部分等。使用独立样本t检验比较抑郁组和非抑郁组MHD患者认知功能的差异,使用简单线性回归、节约模型回归和全校正模型回归分析寻找抑郁和认知功能的预测关系。结果抑郁组与非抑郁组MHD患者基线特质无显著差异。抑郁组患者在蒙特利尔量表(t=-2.380,P<0.05)、Stroop测验C部分(t=2.750,P<0.01)、韦氏成人智力量表图片排列分测验(t=-2.000,P<0.05)和连线测验B(t=2.450,P<0.05)部分的认知功能评分显著低于非抑郁组患者。简单线性回归、节约模型回归和全校正模型回归分析的结果显示抑郁症状越重的MHD患者在蒙特利尔认知评估量表(P=0.010)、Stroop测验C部分(P=0.000)和连线测验B部分(P=0.020)的认知功能评分越差。结论抑郁组和非抑郁组的MHD患者认知功能有显著差异,尤其表现在认知执行功能上。抑郁对MHD患者的认知功能有一定预测作用。

Objective To explore the relationship between depression and cognitive function in maintenance hemodialysis （MHD） patients.Methods A total of 117 MHD patients were divided into depression group and observation group based on the score from the self-rating depression scale （SDS）.Patients in the two groups were assessed by a set of neuropsychological tests including Montreal Cognitive Assessment （MoCA）,Stroop Test,and Trail Making Tests A and B.Independent sample t test was used to compare the cognitive function between the two groups.Regression analyses of simple linear model,parsimonious model and full-adjusted model were used to predict the relationship between depression and cognitive function.Results There were no significant differences in basic characteristics between the two groups.Patients in the depression group had lower scores for MoCA （t=--2.380,P＜0.05）,Stroop C test （t=2.750,P＜0.01）,the Picture Arrangement Test of WAIS-RC （t=--2.00,P＜0.05）,and Trail Making Test B （t=-2.450,P＜0.05） than those in the observation group.Linear regression model,parsimonious model,and full-adjusted model analyses showed that the lower performance of cognitive functions including MoCA,Stroop C test,and Trail Making Test B correlated with the degree of depression symptoms in MHD patients.Conclusion Depressed and none-depressed MHD patients have different cognitive function,especially in the executive functions.Depressed MHD patients are prone to have cognitive impairment.