腹膜透析患者认知功能障碍的相关因素分析

Analysis of the Related Factors to the Cognitive Dysfunction of the Patients with Peritoneal Dialysis

目的评估腹膜透析患者认知功能状况并探讨其相关因素。方法采用方便抽样选取北京市某三级医院肾内科腹透中心2017年7月-2018年6月长期随访患者100例,通过自设问卷和查阅电子病历,收集患者的社会人口学资料和疾病相关资料。联合使用包括蒙特利尔评估量表(MoCA)、数字连接试验(NCT)、Stroop色词测验(CWT)3项神经心理学测验对患者的认知功能进行测评,以综合评估腹透患者认知功能状况并进行相关因素分析。结果100例腹膜透析随访患者MoCA评分15~30分,平均评分(23.03±3.07)分,且校正文化程度的影响,81例(81.00%)患者存在认知功能障碍,仅19例患者(19.00%)认知功能处于正常水平。腹膜透析患者NCT及CWT测评正常构成比高于异常构成比。Logistic回归分析显示,年龄、合并症、透析龄是认知功能的危险因子,而血红蛋白是认知功能的保护因子。结论腹膜透析患者中高龄、透析时间长、合并症多者容易合并认知功能障碍,而血红蛋白是保护因子,应关注腹膜透析患者的认知功能状态。

Objective To evaluate the cognitive function of peritoneal dialysis patients and explore its related factors.Methods A convenient sampling method was used to select 100 long-term follow-up patients from July 2017 to June 2018 in the peritoneal dialysis center of nephrology department of a tertiary hospital in Beijing.The social demographic data and disease-related data of the patients were collected by self-designed questionnaires and electronic medical records.The cognitive function of patients was evaluated by three neuropsychological tests including Montreal Assessment Scale(MoCA),Numerical Connectivity Test(NCT)and Stroop Color Word Test(CWT),so as to comprehensively evaluate the cognitive function of patients with peritoneal dialysis and analyze the related factors.Results The MoCA score of 100 peritoneal dialysis patients ranged from 15 to 30,with an average of(23.03±3.07)scores.After adjusting for the influence of education level,81 patients(81.00%)had cognitive dysfunction,and only 19 patients(19.00%)had normal cognitive function.The normal composition ratio of NCT and CWT in peritoneal dialysis patients was higher than that of abnormal composition ratio.Logistic regression analysis showed that age,complications,dialysis age were risk factors for cognitive function,and hemoglobin was a protective factor for cognitive function.Conclusion Elderly patients with peritoneal dialysis,long dialysis time,and many complications are prone to cognitive dysfunction,and hemoglobin is a protective factor.Attention should be paid to the cognitive function of peritoneal dialysis patients.