血小板相关参数对腹膜透析患者伴发焦虑、抑郁状态的诊断效能

Diagnostic Efficacy of Platelet-Related Parameters on Anxiety and Depression in Patients Undergoing Peritoneal Dialysis

目的分析血小板相关参数与腹膜透析(PD)患者焦虑、抑郁发病的相关性,及其对PD患者伴发焦虑、抑郁状态的诊断效能。方法选取2022年9月至2023年2月河北北方学院附属第一医院PD患者245例,采用广泛性焦虑量表(GAD-7)和患者健康问卷(PHQ-9)分别评估患者焦虑、抑郁情况。收集患者个人信息和生化指标,并检测血小板计数(PLT)、平均血小板体积(MPV)和血小板分布宽度(PDW),采用Logistic回归分析血小板相关参数与PD患者伴发焦虑、抑郁状态的关系。结果245例PD患者中,焦虑发病率为15.9%,抑郁发病率为38.0%。患者透析龄(Z=-2.358,P=0.018;Z=-3.079,P=0.002)、MPV(Z=-4.953,P<0.001;Z=-7.878,P<0.001)、PDW(Z=-4.587,P<0.001;Z=-7.367,P<0.001)在焦虑组和无焦虑组、抑郁组和无抑郁组间差异均有统计学意义。相关性分析显示,MPV(r=0.358,P<0.001;r=0.489,P<0.001)、PDW(r=0.340,P<0.001;r=0.447,P<0.001)与PD患者伴发焦虑、抑郁状态具有正相关性。Logistic回归模型结果显示,MPV(P=0.022,P=0.011)、PDW(P=0.041,P=0.018)、透析龄(P=0.011,P=0.030)是PD患者伴发焦虑、抑郁状态的独立危险因素。MPV诊断PD患者伴发焦虑、抑郁状态的受试者工作特征曲线下面积分别为0.750、0.800;PDW诊断PD患者伴发焦虑、抑郁状态的受试者工作特征曲线下面积分别为0.732、0.780。结论MPV和PDW对PD伴发焦虑、抑郁状态具有较高的诊断效能,可作为评估PD患者伴发焦虑、抑郁状态的客观参考指标。

Objective To analyze the correlations between platelet-related parameters and the incidence of anxiety and depression in the patients undergoing peritoneal dialysis(PD),and evaluate the efficacy of the parameters in the diagnosis of anxiety and depression in PD patients.Methods A total of 245 patients undergoing PD in the First Affiliated Hospital of Hebei North University from September 2022 to February 2023 were enrolled.The generalized anxiety scale(GAD-7)and the patient health questionnaire(PHQ-9)were used to evaluate the anxiety and depression of the patients,respectively.The personal information and biochemical indicators of the patients were collected,and the platelet count(PLT),mean platelet volume(MPV),and platelet distribution width(PDW)were measured.Logistic regression was adopted to analyze the relationships of platelet-related parameters with anxiety and depression in PD patients.Results Among the 245 patients undergoing PD,the incidences of anxiety and depression were 15.9%and 38.0%,respectively.There were differences in the dialysis period(Z=-2.358,P=0.018;Z=-3.079,P=0.002),MPV(Z=-4.953,P<0.001;Z=-7.878,P<0.001),and PDW(Z=-4.587,P<0.001;Z=-7.367,P<0.001)between the anxiety group and the non-anxiety group as well as between the depression group and the non-depression group.The correlation analysis showed that MPV(r=0.358,P<0.001;r=0.489,P<0.001)and PDW(r=0.340,P<0.001;r=0.447,P<0.001)were positively correlated with anxiety and depression in the patients undergoing PD.The Logistic regression model showed that MPV(P=0.022,P=0.011),PDW(P=0.041,P=0.018),and dialysis period(P=0.011,P=0.030)were independent risk factors for the anxiety and depressive state in PD patients.The areas under the receiver operating characteristic curve of MPV in the diagnosis of anxiety and depression in PD patients were 0.750 and 0.800,respectively,and those of PDW were 0.732 and 0.780,respectively.Conclusion MPV and PDW have high efficacy in the diagnosis of anxiety and depression associated with PD and can be used as objective indicators to evaluate the anxiety and depression in the patients undergoing PD.