肾移植患者术后的抑郁情况分析及其影响因素

Analysis of depression in renal transplant patients and its influencing factors

目的调查肾移植患者术后近期的抑郁发展动态,并分析其影响因素。方法采用纵向研究设计,回顾性分析2018年8月-2019年1月期间共128例终末期肾病患者接受肾移植手术的临床资料。采用自行设计的一般问卷了解社会人口学资料,抑郁自评量表(self-rating depression scale,SDS)测量抑郁情况,通过采集血液学标本监测血红蛋白和血肌酐水平。测量时间为肾移植术前(T0)与术后1个月(T1)、2个月(T2)、3个月(T3)4个时间点。利用重复测量方差分析比较4次测量的结果,利用广义估计方程分析肾移植患者术后近期抑郁的影响因素。结果患者抑郁得分分别为60.14±8.440、51.12±9.092、49.55±8.597、48.79±7.992;抑郁症状检出率分别为91.6%、53.9%、41.4%、44.5%。移植后时间、学历、血红蛋白水平为患者抑郁的影响因素。结论终末期肾病患者的抑郁症状在接受肾移植后1个月内迅速好转,但仍有部分患者存在中重度抑郁症状,且抑郁水平是动态变化的。硕士学历、低血红蛋白水平的患者抑郁水平较高。

Objective The purpose of this study was to investigate the development of early post-transplant depression in renal transplant patients and analyze the influencing factors. Methods A longitudinal study was designed to retrospectively analyze the clinical data of 128 patients with end-stage renal disease who received kidney transplantation from August 2018 to January 2019. A self-designed general questionnaire was used to understand the sociodemographic information and measure depression with the Self-rating Depression Scale( SDS). Hemoglobin and creatinine levels were monitored by collecting hematological samples. The measurement time was before(T0), 1 month(T1), 2 months(T2) and 3 months(T3) after renal transplantation. The differences between the four measurements were compared with the repeated measures analysis of variance, the influence factors of depression were analyzed by using the generalized estimation equation. Results The depression scores of the patients were 60.14±8.44051.12±9.092, 49.55±8.597 and 48.79±7.992. Rates of depressive symptoms were 91.6%, 53.9%, 41.4% and 44.5%, respectively. Post-transplant time, educational background and hemoglobin level were determined to be the influencing factors of depression. Conclusion The depressive symptoms of patients with end-stage renal disease improved rapidly within 1 month after receiving kidney transplantation. Some patients still had moderate and severe depressive symptoms, and the depression level was dynamic. Education levels and hemoglobin had a lasting effect on the depression status of kidney transplant patients in the immediate future.