PCI术后急性肾损伤实施CRRT患者焦虑抑郁状态的危险因素分析

Risk Factors for Anxiety and Depression in Patients Undergoing CRRT for Acute Kidney Injury after PCI

目的分析经皮冠状动脉介入治疗(PCI)术后合并对比剂诱导的急性肾损伤(CI-AKI)实施持续性肾替代治疗(CRRT)患者焦虑及抑郁状态的相关危险因素。方法 对107例PCI术后合并急性肾损伤实施CRRT患者在1周内进行焦虑自评量表(SAS)和抑郁自评量表(SDS)调查,并收集患者的临床资料,分析与焦虑和抑郁发生相关的危险因素。结果 107例患者中有焦虑抑郁状态者75例,单因素回归分析显示是否合并高血压病或糖尿病、高心功能分级、吸烟、性格内向及文化水平低均对SAS、SDS的评分有显著性影响,差异有统计学意义(P<0.01),多因素回归分析显示吸烟、糖尿病、性格内向是CI-AKI患者发生焦虑抑郁状态的独立危险因素。结论 PCI术后合并急性肾损伤实施CRRT患者中合并高血压病或/和糖尿病、高心功能分级、吸烟、性格内向、文化水平低者更易产生术后焦虑抑郁状态,吸烟、糖尿病、性格内向是影响CI-AKI患者焦虑、抑郁水平的独立危险因素,提示临床医师应对这些类型患者的精神心理状态予以特别重视。

Objective To investigate the risk factors for anxiety and depression in patients receiving continuous renal replacement therapy(CRRT)for contrast-induced acute kidney injury(CI-AKI)after percutaneous coronary intervention(PCI).Methods One hundred and seven patients with acute kidney injury after PCI were investigated by Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)within 1 week after CRRT.The clinical data were collected to analyze the related risk factors for anxiety and depression.Results Among the 107 patients,75 had anxiety and depression.Univariate regression analysis showed that hypertension/diabetes,NYHA functional class,smoking,introversion and low literacy exerted significant impact on SAS and SDS scores(P<0.01).Multivariate regression analysis showed that smoking,diabetes and introversion were independent risk factors for anxiety and depression in CI-AKI patients.Conclusion Patients with hypertension/diabetes,NYHA functional class,smoking,introversion or low literacy are more likely to have anxiety and depression after CRRT for acute kidney injury.Smoking,diabetes and introversion are independent risk factors for anxiety and depression in CI-AKI patients.Therefore,clinicians should pay special attention to the mental state of these patients.