腹膜透析患者认知障碍及其危险因素的研究

Cognitive impairment and its risk factors in peritoneal dialysis patients

目的了解腹膜透析(PD)患者认知障碍(CI)发生率,探讨PD患者CI的非传统血管相关危险因素。方法选取持续不卧床腹膜透析(CAPD)患者54例为研究对象,使用《蒙特利尔认知评估量表(MoCA)》对CAPD患者认知功能进行评估,根据评分结果分为CI组和认知正常组,分析对比2组间CI的相关影响因素。结果CI在CAPD患者的发生率为55.6%。CI组总胆固醇水平高于认知正常组(P<0.05),其受教育水平、血尿酸水平低于认知正常组(P<0.05)。Logistic回归分析结果显示,高龄、受教育水平低下、高胆固醇血症、超敏C反应蛋白(hs-CRP)升高是CAPD患者CI的独立危险因素(P<0.05),残余肾功能是CAPD患者CI的保护因素(P<0.05)。结论hs-CRP升高是CAPD患者CI的独立危险因素,残余肾功能是CAPD患者CI的保护因素。

Objective To investigate the incidence of cognitive impairment(CI)in peritoneal dialysis(PD)patients and to explore the non-traditional vascular-related risk factors of CI in PD patients.Methods 54 patients with continuous ambulatory peritoneal dialysis(CAPD)were selected as the research object.The cognitive function of CAPD patients was evaluated by Montreal Cognitive Assessment Scale(MoCA).54 patients with continuous ambulatory peritoneal dialysis(CAPD)were selected as the research objects.The cognitive function of CAPD patients was evaluated by the Montreal Cognitive Assessment Scale(MoCA).According to the scoring results,they were divided into CI group and cognitive normal group,and the related influencing factors of CI between the two groups were analyzed and compared.Results The incidence of CI in CAPD patients was 55.6%.The level of total cholesterol level in the CI group was higher than that in the cognition normal group(P<0.05),and its education level and blood uric acid level were lower than that of the cognition normal group(P<0.05).Logistic regression analysis showed that advanced age,low education level,hypercholesterolemia,and elevated hs-CRP were independent risk factors for CI in CAPD patients(P<0.05),and residual renal function was a protective factor for CI in CAPD patients(P<0.05).Conclusion The increase of hs-CRP is an independent risk factor for CI in CAPD patients,and residual renal function is a protective factor for CI in CAPD patients.