维持性血液透析患者焦虑抑郁状态的变化特点及临床意义

Characteristics of changes and clinical significance of anxiety and depression in maintenance hemodialysis patients

目的:观察维持性血液透析患者焦虑抑郁状态的变化特点及临床意义。方法:选取长期随访的血液透析患者100例,按纳入研究时焦虑抑郁积分分为A组(焦虑抑郁阳性)和B组(焦虑抑郁阴性);再依据时间平均的焦虑抑郁积分分为C组和D组。所有患者在研究期间仍延续常规血液透析替代治疗和尿毒症并发症药物治疗;A组给予黛力新药物治疗。比较两组外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)指标水平及其与时间平均的焦虑抑郁积分的相关性。结果:A组CD4、CD4/CD8比值显著低于B组,差异有统计学意义(P<0.05)。A组治疗后CD4、CD4/CD8比值较前升高,但差异无统计学意义(P>0.05)。C组CD4、CD4/CD8比值低于D组,差异有统计学意义(P<0.05)。时间平均的焦虑抑郁积分与CD4呈负相关,与CD4/CD8呈显著负相关,差异有统计学意义(P<0.05)。结论:时间平均的焦虑抑郁积分是导致血液透析患者细胞免疫功能紊乱的重要原因之一。

Objective:To explore the characteristics of changes and clinical significance of anxiety and depression in maintenance hemodialysis patients.Methods:100 hemodialysis patients with long-term follow-up were selected and divided into group A(positive anxiety and depression)and group B(negative anxiety and depression)according to the anxiety and depression scores when they were included in the study.According to the time average score of anxiety and depression,they were divided into group C and Group D.During the study period,all patients continued to receive routine hemodialysis replacement therapy and uremic complications medication.Group A was treated with Delixin.We compared the indexes of peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)between the two groups and their correlation with the time average score of anxiety and depression.Results:In group A,the CD4 and ratio of CD4/CD8 was significantly lower than that in group B,the difference was statistically significant(P<0.05).The CD4 and ratio of CD4/CD8 in group A was higher than before,but the difference was not statistically significant(P>0.05).The CD4 and ratio of CD4/CD8 in group C was lower than that in group D,the difference was statistically significant(P<0.05).The time average score of anxiety and depression was negatively correlated with CD4,and significantly negatively correlated with CD4/CD8,the difference was statistically significant(P<0.05).Conclusion:The time average score of anxiety and depression is one of the important reasons for the disorder of cellular immune function in hemodialysis patients.