甲状腺素及抵抗素与维持性血液透析患者抑郁状态的相关性研究

Correlation of thyroxine and resistin with depression in patients with maintenance hemodialysis

目的维持性血液透析(MHD)患者的抑郁情况并分析与甲状腺素及抵抗素相关性。方法选取2020年3月—2020年9月于遵义医科大学第五附属(珠海)医院规律血液透析患者162例,采用PHQ-9抑郁症筛查量表进行抑郁心情的评估,并分析其影响因素。测血白蛋白、甲状腺素、抵抗素等血清学指标。按PHQ-9抑郁症筛查量表分为抑郁组及非抑郁组。结果162例MHD患者抑郁发生率为33.33%。抑郁组与非抑郁组比较,C-反应蛋白(CRP)、游离三碘甲状腺原氨酸(FT 3)、抵抗素差异有统计学意义(P<0.05),在白细胞、血红蛋白、白蛋白、血尿酸、肌酐、尿素、三碘甲状腺原氨酸(T 3)、血钠、血钾、甲状旁腺激素(PTH)、总胆固醇、甘油三酯、维生素D3方面差异无统计学意义(P>0.05)。CRP(r=0.241,P=0.002)、抵抗素(r=0.382,P<0.001)、尿素(r=0.155,P=0.048)与抑郁评分呈正相关,FT 3(r=-0.188,P=0.017)与抑郁评分呈负相关。多元线性回归分析结果显示CRP、抵抗素有统计学差异(P<0.05),CRP(标准化偏回归系数β=0.205,P=0.004)、抵抗素(标准化偏回归系数β=0.333,P<0.001)是MHD患者抑郁的独立危险因素。结论MHD患者抑郁状态与CRP、抵抗素有关。

Objective To investigate the depression of patients with maintenance hemodialysis(MHD)and analyze its relation with thyroxine and resistin.Methods This study selected a total of 162 patients who got regular MHD in the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University from March 2020 to September 2020.PHQ-9 depression screening scale was used to evaluate their depression mood and relevant influencing factors were analyzed.We detected their serological indexes such as albumin,thyroxine and resistin.According to the PHQ-9 depression screening scale,they were divided into the depression group and non-depression group.Results The incidence of depression in 162 MHD patients was 33.33%.There were significant differences in C-reactive protein(CRP),free triiodothyronine(FT 3)and resistin between the depression group and the non-depression group(P<0.05).However,there were no significant differences in WBC,hemoglobin,albumin,serum uric acid,creatinine,urea,T 3(triiodothyronine),serum sodium,serum potassium,parathyroid hormone(PTH),total cholesterol,triglyceride and vitamin D3 between two groups(P>0.05).CRP(r=0.241,P=0.002),resistin(r=0.382,P<0.001),urea(r=0.155,P=0.048)were positively correlated with the depression score,and FT 3(r=0.188,P=0.017)was negatively correlated with depression score.Multiple linear regression analysis showed that CRP and resistin were significantly different(P<0.05).CRP(normalized partial regression coefficientβ=0.205,P=0.004)and resistin(normalized partial regression coefficientβ=0.333,P<0.001)were independent risk factors for depression in MHD patients.Conclusion The depression of MHD patients is related with their CRP and resistin.