持续非卧床腹膜透析患者产生抑郁情绪的多因素分析及生活质量评估

Depression in patients with continuous ambulatory peritoneal dialysis: incidence and impact on quality of life

目的探讨接受持续性非卧床腹膜透析(CAPD)患者抑郁症状的发病情况及CAPD患者抑郁情绪与营养状况及炎症状态的关系,评估该类患者的生活质量。方法选取腹膜透析龄>3个月的患者105例,填写Zung自评抑郁量表(SDS)及生活质量量表(SF-36),SDS标准分≥53分为抑郁,记录CAPD患者一般情况及生化指标,依据是否白蛋白水平<38 g/L,降钙素原水平>0.05 ng/ml进行赋值分组。结果CAPD患者抑郁的发生率为58.1%(61/105),男性为21.9%(23/105),女性为36.2%(38/105);与非抑郁组患者比较,抑郁组患者年龄偏大、女性较多、白蛋白水平减低、降钙素原水平增高、血红蛋白水平降低、β2微球蛋白水平增高、透析龄长(P<0.05)。同时存在血清白蛋白水平<38 g/L,降钙素原水平>0.05 ng/ml两个因素的患者发生抑郁的风险有所增加。结论终末期肾脏病患者接受CAPD治疗后抑郁的发生率较高,女性患病率高于男性;发生情绪障碍的CAPD患者生活质量下降;营养状况、炎症状态是腹膜透析患者发生抑郁的危险因素。

Objective To investigate the incidence of depressive symptoms in patients receiving continuous ambulatory peritoneal dialysis(CAPD)and the relationship between depression and nutritional status and inflammatory status in patients with CAPD,and assess the quality of life of these patients.Methods A total of 105 patients who had undergone peritoneal dialysis for>3 months were selected.All participants completed the Zung Self-rating Depression Scale(SDS)and quality of life scale(SF-36),and patients with an SDS score of 53 or more were considered to have depression.The general conditions and biochemical indicators of CAPD patients were recorded,and they were divided into groups based on the values of albumin(Alb;<38 g/L)and procalcitonin(>0.05 ng/ml).Results The incidence of depression in CAPD patients was 58.1%(61/105)in the overall population,21.9%(23/105)in men,and 36.2%(38/105)in women.Compared with patients in the non-depression group,patients in the depression group were more likely to be female and older,and had significantly lower albumin,higher procalcitonin levels,lower hemoglobin levels,higherβ2 microglobulin levels,and longer dialysis duration(P<0.05).Patients with both serum albumin levels less than 38 g/L and procalcitonin greater than 0.05 ng/ml had an increased risk of depression.Conclusion Patients with end-stage renal disease have a higher incidence of depression after receiving CAPD.The incidence of depression is higher in females than in males.The quality of life of CAPD patients with emotional disorders is reduced.Nutritional status and inflammatory status are risk factors for depression in peritoneal dialysis patients.