老年糖尿病肾病患者营养状况与焦虑、抑郁水平及认知功能的相关性研究

Correlation among nutritional status and anxiety, depression and cognitive function in elderly patients with diabetic nephropathy

目的 了解老年糖尿病肾病患者焦虑、抑郁和认知水平,探讨其与营养状况的关系,为改善患者的营养和健康状况提供依据.方法 选择符合纳入标准的老年糖尿病肾病患者80例,采用SAS、SDS和简易智能精神状态检查量表（MMSE）评估患者的焦虑、抑郁程度和认知水平,应用微型营养评价量表（MNA）描述患者的营养状况.结果 患者SAS评分为（53.52±16.49）分,焦虑发生率为62.5%;SDS评分为（55.41±13.27）分,抑郁发生率为65.0%;MMSE评分为（27.36±5.41）分,认知功能下降的发生率为47.5%;应用MNA评估结果为营养不良者占12.5%,营养不良临界状态者占67.5%,营养良好者占20.0%.MNA得分与MMSE得分之间存在正相关,与SAS、SDS得分存在负相关（P〈0.01）.结论 患者的营养状况与焦虑、抑郁和认知水平之间的相关性不容忽视,医务人员在对患者实施营养干预的过程中,应关注患者的心理状态及认知功能,以减少负性情绪的发生,改善患者的营养和健康状况.

Objective To evaluate the status of anxiety, depression and cognitive function of elderly patients with diabetic nephropathy（DN）, and their relation with nutritional status, in order to provide evidence to improve nutritional status of elderly DN patients.Methods A total of 80 elderly DN patients were investigated with self-rating anxiety scale（SAS）,self-rating depression scale（SDS）,mini mental state examination（MMSE）for the patients＇ level of anxiety, depression and recognition and mini nutrition assessment scale（MNA） for patients＇ nutrition.Results SAS score was （53.52±16.49） with an incidence rate of 62.5%; SDS score was （55.41±13.27） with an incidence rate of 65.0%; MMSE score was （27.36±5.41） and the incidence rate of cognitive function declining was 47.5%. The prevalence of malnutrition, potential malnutrition and the well- nourished were 12.5%, 67.5%, 20.0%,respectively. The MNA grade had a positive correlation with cognitive function, but had a negative correlation with anxiety and depression （P〈0.01）.Conclusions The correlation among nutritional status with anxiety, depression and cognitive function can not be ignored. Medical personnel should be prepared to take mental intervention to correct the nutritional status of patients, improve their health status and quality of life, as well as reduce negative emotion and pay attention to their psychological status and cognition function.