腹膜透析患者胃肠道症状与心理状况的研究

Gastrointestinal symptoms and psychological features in peritoneal dialysis patients

目的探讨腹膜透析患者胃肠道症状与心理状况异常的发生情况及相关性。方法我院腹膜透析患者89例,采用胃肠道症状分级评分量表中文版、汉密尔顿焦虑量表和汉密尔顿抑郁量表评估患者胃肠道症状发生情况及心理状况。记录年龄、性别、透析时间、体质量指数、血压、血红蛋白、校正钙、磷、全段甲状旁腺激素(i PTH)、白蛋白、血肌酐、尿素氮、Kt/V等指标。结果腹膜透析患者胃肠道症状分级评分>1分的发生率为83.1%。心理状况调查显示中度抑郁患者2例,可能抑郁患者23例,焦虑患者13例,可能焦虑患者19例,焦虑/抑郁的总发生率为50.6%。焦虑/抑郁组患者的胃肠道评分明显高于非焦虑/抑郁组患者(P<0.05)。相关分析提示胃肠道症状分级评分与焦虑、抑郁及BMI呈明显正相关,与Kt/V呈负相关(P<0.05)。结论腹膜透析患者存在突出的胃肠道症状,也有较高的焦虑/抑郁发生率。焦虑/抑郁心理状况与患者的胃肠道症状之间存在明显相关性。

Objective To investigate the occurrence of gastrointestinal symptoms and psychological abnormal state and their relationship in peritoneal dialysis （ PD） patients.Methods Gastrointestinal symptoms and psychological state of 89 PD patients treated in our hospital were assessed by using the gastrointestinal symptom rating scale （ GSRS） ,Hamilton Anxiety Scale （ HAMA） and Hamil-ton Depression Scale （HAMD）.Patients＇age,gender,dialysis duration,body weight index （BMI）,blood pressure,blood hemoglobin, calcium,phosphorus,intact parathyroid hormone,albumin,creatinine,urea nitrogen and Kt/V were examined.Results The prevalence of troublesome gastrointestinal symptoms （ GSRS 〉1 ） was 83.1% in the study population.The investigation of psychological state showed that there were 2 patients with mild depress,23 patients with possible depress,13 patients with anxiety and 19 patients with pos-sible anxiety.The total rate of depress/anxiety was 50.6%.The GSRS scores in the depress/anxiety group were much higher than non-depress/anxiety group （P〈0.05）.Correlation analysis showed that GSRS scores were positively correlated with depress/anxiety and BMI,while negatively correlated to Kt/V （P〈0.05）.Conclusion The PD patients have high levels of gastrointestinal symptoms and high incidence of depression and anxiety.A remarkable correlation is observed between gastrointestinal symptoms and psychological state.