慢性肾衰竭患者尿毒症期并发脑病的发生率和危险因素分析

The incidence and risk factors of encephalopathy in uremic patients with chronic renal failure

目的探讨慢性肾衰竭（CRF）患者尿毒症期并发脑病的发生率及相关危险因素。方法回顾289例慢性肾衰竭尿毒症期患者的临床资料，其中发生尿毒症脑病（UE）32例，对尿毒症脑病的可能危险因素进行LOGISTIC单因素回归分析，筛选出显著的因素进行LOGISTIC多因素回归分析，并行分级评分，按总分将患者分为危险组、高危组、极危组，分析各组UE发生率。结果血肌酐、收缩压、血钾、二氧化碳结合力、是否定期血滤和灌流、SCL-90心理评分、感染、抗生素为CRF患者发生尿毒症脑病的显著危险因素。危险组UE发生率为1．71％，高危组为12．14％，极危组为40．63％，三组差异有统计学意义（P〈0．05）。结论CRF患者并发UE的因素复杂，治疗时应积极治疗原发病和并发症，加强对负面情绪严重患者的健康教育和心理干预。

Objective To investigate the incidence and related risk factors of encephalopathy in uremic patients with chronic renal failure （CRF）. Methods Clinical data of 289 uremic patients with CRF was reviewed, in whom there were 32 cases of uremic encephalopathy （UE）. Carried out LOGISTIC single factor regression analysis for possible risk factors of UE, screened out significant factors for LOGISTIC multivariate regression analysis, carried out rating scale, the patients were divided into risk group, high risk group, and critically risk group, analyzed the incidence of UE of each group. Results Serum creatinine, systolic blood pressure, blood potassium, carbon dioxide binding force, whether regular blood filtration and perfusion, SCL-90 psychological score, infection, antibiotics use were significant risk factors of uremia encephalopathy for CRF patients. The incidence of UE in risk group was 1.71%, 12.14% in high risk group, 40.63% in critically risk group, with statistically significant difference among three groups （P〈0.05）. Conclusion The risk factors of UE for CRF patients were complicated, primary disease and complications should be actively treated, we should strengthen the health education and psychological intervention of patients with serious negative emotions.