诊断学理论与实践

诊断学理论与实践 ›› 2017, Vol. 16 ›› Issue (04): 390-393.doi: 10.16150/j.1671-2870.2017.04.009

• 论著 • 上一篇    下一篇

维持性血液透析患者抑郁发生情况及相关因素分析

鲁嘉越1, 占雅萍1, 张伟明1, 李萍1, 刘上1, 朱旻霞1, 蔡宏1, 倪兆慧2   

  1. 1.上海交通大学医学院附属仁济医院南院肾脏科,上海 201112;
    2.上海交通大学医学院附属仁济医院肾脏科,上海 200127
  • 收稿日期:2017-07-03 出版日期:2017-08-25 发布日期:2017-08-25
  • 通讯作者: 张伟明 E-mail: weimingzh1965@163.com
  • 基金资助:
    上海交通大学医学院附属仁济医院南院临床学科创新共建平台建设项目（2014MDT02）

Analysis of depression and related factors in maintenance hemodialysis patients

LU Jiayue1, ZHAN Yaping1, ZHANG Weiming1, LI Ping1, LIU Shang1, ZHU Minxia1, CAI Hong1, NI Zhaohui2   

  1. 1. Department of Nephrology, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China;
    2. Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2017-07-03 Online:2017-08-25 Published:2017-08-25

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摘要： 目的: 采用横断面调查分析我院透析中心维持性血透患者的抑郁发生率及其相关影响因素。方法: 以我院透析中心维持性血液透析患者为调查对象,采用贝克抑郁自评量表（Beck Depression Inventory,BDI）对其进行抑郁状态评估,并根据BDI评分将其分为正常组（BDIs≤10分）和情绪异常组（BDIs>10分）,分析2组患者的抑郁发生情况及相关影响因素。结果: 109例纳入研究的维持性血液透析患者中100例完成问卷调查,完成率为91.7%,其中男性60例,女性40例;年龄为27~86岁,平均年龄为（58±14）岁;透析龄为3~165个月,平均透析龄为（43±39）个月。情绪正常患者为69例,情绪异常患者为31例（31.0%）[轻度情绪异常者（10<BDIs≤15分）16例,抑郁患者15例（15.0%）（15<BDIs≤25分9例,>25分6例）]。情绪正常组与异常组患者在年龄、透析龄、教育程度、家人陪伴、透析日程安排、透析相关并发症、血红蛋白、血浆白蛋白、全段甲状旁腺素（intact parathyroid hormone,iPTH）及单室Kt/V（single pool Kt/V,spKt/V）方面差异均无统计学意义,仅在女性比例上存在差异（P<0.05）。线性回归方程结果显示,BDI评分与spKt/V呈负相关（r=-0.27,P<0.05）。结论: 我院维持性血液透析患者的抑郁发生率高,尤其是女性患者,而透析不充分可能会加重患者的抑郁程度。定期在透析中心开展对抑郁的筛查,有助于早期发现透析患者的情绪异常,并及早进行心理干预及药物治疗,提高透析患者的生存质量。

关键词: 终末期肾衰竭, 血液透析, 抑郁症

Abstract: Objective: To analyze the prevalence of depression in maintenance hemodialysis patients in our dialysis center and its related factors by cross-sectional study. Methods: Beck Depression Inventory(BDI) was used to assess the depression occurred in patients of our dialysis center. According to the BDI score, patients were divided into normal group (BDIs≤10) and emotional disorders group(BDIs>10). The prevalence of depression and related factors were analyzed in these two groups. Results: Of the 109 maintenance hemodialysis patients, 100 completed the questionnaires, with a completion rate of 91.7%. There were 60 males and 40 females, with an average age of (58±14) years (27-86 years), and an average dialysis age of (43±39) months (3-165 months). There were 69 cases in normal group and 31 cases in emotional disorder group (16 cases with 10<BDIs≤15, 9 cases with 15<BDIs≤25 and 6 cases with BDIs>25); 15 cases had depression(15.0%). There were no statistical differences in age, dialysis age, education, family support, arrangement of dialysis, dialysis related complications, hemoglobin, serum albumin, iPTH and spKt/V between the two groups, the only difference was the proportion of females (P<0.05). The linear regression equation showed that the BDI score was negatively correlated with spKt/V (r=-0.27, P<0.05). Conclusions: The prevalence of depression in maintenance hemodialysis patients in our dialysis center is high, especially in female patients. Inadequate dialysis might increase the severity of depression in the patients.Regular screening of depression at dialysis center is helpful for early detection of emotional disorders in dialysis patients, and early psychological intervention and drug treatment could be taken to improve the quality of life in dialysis patients.

Key words: End stage renal disease, Hemodialysis, Depression

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