维持性血液透析患者认知功能障碍与脉压的相关性探讨

Congnitive dysfunction in patients with maintenance hemodialysis and the correlation of pulse pressure

目的:探讨维持性血液透析患者(MHD)认知功能障碍(CI)与脉压(PP)的相关性。方法:选择透析患者120例,采用蒙特利尔认知评估表(Mo CA)行认知功能评分,将患者分为CI组与非CI组,检测各患者脉压和横断面,调查年龄、性别、受教育年限、并发症、透析龄等临床数据。将两组各数据进行对比分析。结果:68例发生CI,发生率为56.7%;两组患者性别、透析龄比较差异无统计学意义(P>0.05);CI组年龄、脉压明显大于非CI组(P<0.05);CI组受教育年限短于非CI组(P<0.05);CI组高血压、糖尿病、冠心病占37.2%,明显高于非CI组(P<0.05)。68例CI患者中,脉压与Mo CA评分呈负相关(P<0.05);Logistic回归分析显示,年龄、受教育年限、并发症、脉压是MHD患者CI的独立危险因素。结论:脉压在维持性血液透析患者中偏高,且为患者发生认知功能障碍的重要危险因素之一。

Objective： On patients with maintenance hemodialysis（ MHD） cognitive dysfunction（ CI） and the correlation of pulse pressure（ PP）. Methods： In the hospital,120 cases of dislysis patients,the Montreal cognitive assessment（ Mo CA） line of cognitive function score,divided the patients into CI group or the CI- free groups,pulse pressure detecting various patients,cross- sectional survey fixed number of year of the age,gender,education,complications or complications,age of dialysis and other clinical data. To compare data analysis of two groups. Results： All 68 cases of CI,the rate of 56. 7%. There is no difference with gender and age of dialysis of two groups patients（ P〉0. 05）,Age,pressing of arteries and veins in CI group was obviously greater than CI- free group,（ P〈0. 05）,in CI group education years shouter than CI- free group（ P〈0. 05）,hypertension,diabetes,coronary heart disease in CI group of was 37. 2%,significantly higher than CI- free group（ P〈0. 05）. In 68 patients with CI,pulse pressure and negatively correlated with Mo CA score（ P〈0. 05）. Logistic regression analysis showed that age,by education years,complications,pulse pressure is the independent risk factors for the development of CI MHD patients.Conclusion： Pulse pressure in patients with maintenance hemodialysis on the high side,and the occurrence of cognitive dysfunction in patients with one of the important risk factors.