容量负荷增加对维持性血液透析患者焦虑、抑郁状态的影响

Effects of increased volume load on anxiety and depression in maintenance hemodialysis patients

目的观察容量负荷增加对维持性血液透析(MHD)患者焦虑、抑郁状态的影响。方法选择2016年12月-2018年12月河北省保定市徐水区人民医院收治的MHD患者55例为MHD组,另选择同期门诊健康体检者55例为健康对照组。比较2组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、左室后壁厚度、左室舒张末期内径、左室收缩末期内径,并分析MHD组透析间期体质量增长值及收缩压升高值,分析SAS、SDS评分值与透析间期体质量增长值、收缩压升高值、左室后壁厚度、左室舒张末期内径、左室收缩末期内径的相关性。结果MHD组SAS评分、SDS评分、左室后壁厚度、左室舒张末期内径、左室收缩末期内径均高于对照组(P<0.01);SAS评分与体质量增长值、收缩压增长值呈正相关(r=0.713、P=0.003,r=0.697、P=0.001),SDS评分与左室后壁厚度、左室收缩末期内径呈正相关(r=0.637、P=0.002,r=0.685、P=0.005)。结论MHD患者焦虑、抑郁与体质量增长值、收缩压升高值、左室后壁厚度、左室收缩末期内径均有一定相关性,可通过控制容量负荷增加缓解其焦虑、抑郁状态。

Objective To observe the effect of increased volume load on anxiety and depression in maintenance hemodialysis(MHD)patients.Methods From December 2016 to December 2018,55 MHD patients admitted to Baoding Xushui District People’s Hospital,Hebei Province were selected as MHD group.In addition,55 healthy subjects were selected as healthy control group.The scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),left ventricular posterior wall thickness,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were compared between the two groups,the increase in body mass and systolic blood pressure in the MHD group were analyzed.The correlation of SAS and SDS scores with interdialytic body mass increase,systolic blood pressure increase,left ventricular posterior wall thickness,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were analyzed.Results The SAS scores,SDS score,left ventricular posterior wall thickness,left ventricular end-diastolic diameter,left ventricular end systolic diameter in MHD group were higher than control group(P<0.01).The SAS scores and growth of body quality,systolic blood pressure were positively correlated(r=0.713,P=0.003,r=0.697,P=0.001).The SDS scores and left ventricular posterior wall thickness,left ventricular end systolic diameter were positively correlated(r=0.637,P=0.002,r=0.685,P=0.005).Conclusion Anxiety and depression in MHD patients are correlated with body mass increase,systolic blood pressure increase,left ventricular posterior wall thickness,and left ventricular end-systolic diameter to some extent,which can be alleviated by controlling volume load increase.