抑郁障碍对血液透析患者的影响

The Effect of Depression on Hemodialysis Patients

目的 探讨尿毒症患者产生抑郁障碍的可能因素及其对血液透析的影响 ,并尝试药物治疗 ,改善患者的生活质量。方法 选择无精神病史的规律性血透患者 5 1例 ,进行汉密尔顿抑郁量表(HAMD ,2 4项版本 )评分 ,并分为抑郁组和非抑郁组 ;在组间进行性别、年龄、文化程度和经济状况的比较 ,观察患者透析充分性、营养、就业率及顺应性在组间的差异。选择重度抑郁状态者予博乐欣 ( 75～1 5 0mg d)抗抑郁治疗 ,观察疗效。结果 ( 1 ) 35 .3%的患者存在抑郁障碍 ;( 2 )两组的年龄、性别、文化程度和婚姻障碍情况均无显著差异 ;( 3)两组间在医疗付费方式、透前规律性肾科门诊及顺应性、充分性、营养状态方面存在显著差异 ;( 4 )在 1 8例中选 7例抗抑郁治疗 ,1个月后HAMD评分均有不同程度下降。结论 抑郁障碍在血透患者中是常见的。它可造成血透患者的顺应性下降、营养不良、透析不充分等。

Objective To investigate the possible reasons of depression on uremia patients and the effect of depression on hemodialysis and to use the medicine to improve the life quality.Methods 51 hemodialysis patients without psychotic disorder were selected. Patients were divided into two groups (depression group and normal group) by Hamilton depression scale(HAMD). Dialysis adequacy, nutritional status and compliance between two groups were compared. The patients with severe depression were taken medicine (venlafaxine hydrochloride capsules 75～150 mg/d).Results (1) 35.3% patients were suffered from depression. (2) There were no difference in age, sex, education and marriage between two groups. (3) The patients in depression group had lower level of adequacy, worse nutritional status and less compliance than those in normal group. (4) 7 patients in depression group were improved with venlafaxine hydrochloride capsules. Conclusion Depression is very common in hemodialysis patients. Depression may result in malnutrition, noncompliance and dialysis inadequacy, etc. Depression can be improved with venlafaxine hydrochloride capsules.