维持性血液透析患者生化指标与心理功能的相关性及影响因素

doi:10.3969/j.issn.1006-6233.2018.03.047

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摘要 目的: 探讨维持性血液透析患者生化指标与心理功能的相关性,并分析其影响因素。方法: 以2015年11月至2016年12月我院收治的58例接受维持性血液透析治疗患者[研究组(依据维持性血液透析后患者心理功能分为心理功能差组和心理功能良好组)]和同期在我院体检的30例健康志愿者(健康组)为对象,比较两组生化指标[血红蛋白(Hb)、总蛋白(TP)、白蛋白(Alb)、前白蛋白(PA)、血肌酐(SCr)、血尿素氮(BUN)、血钙(Ca)、脑源性神经营养因子(BDNF)]和心理功能[采用精神症状自评量表(SCL-90)评估],并进行相关性分析,同时采用多元回归Logistic分析法分析心理功能的独立影响因素。结果: 三组Hb、Alb、BDNF两两相较有显著性差异(P<0.05);心理功能差组PA、SCr、BUN、Ca与健康组相较差异显著(P<0.05),心理功能良好组BUN与健康组相较差异明显(P<0.05),三组间TP相较无明显差异(P>0.05);心理功能差组SCL-90评分较心理功能良好组、健康组明显高,三组间两两相较有显著性差异(P<0.01);Hb、Alb、BDNF是持续性血液透析患者心理功能的独立影响因素(P<0.05)。结论: 维持性血液透析患者生化指标和心理功能较健康人群有较大差异,Hb、Alb、BDNF变化是维持性血液透析患者心理功能的重要影响因素,临床上应加强相关指标的监测。

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	何俊

关键词 ：维持性血液透析, 生化指标, 心理功能, 相关性, 影响因素

Abstract：Objective: To explore the correlation of biochemical indexes and psychological function in maintenance hemodialysis patients, and to analyze the influencing factors. Methods: 58 patients undergoing maintenance hemodialysis (study group) in our hospital during the period from November 2015 to December 2016 and 30 healthy volunteers (healthy group) who received physical examination in our hospital during the same period were selected as the subjects. Patients in the study group were divided into the poor psychological function group and the good psychological functiongroup according to the psychological function in patients undergoing maintenance hemodialysis. The biochemical parameters hemoglobin (Hb), total protein (TP), albumin (Alb), prealbumin (PA), serum creatinine (SCr), blood urea nitrogen (BUN), serum calcium (Ca), brain-derived neurotrophic factor (BDNF) and psychological function evaluated with the psychiatric symptom checklist (SCL-90) were compared between the two groups, and correlation analysis was performed. The independent influencing factors of psychological function were analyzed by multiple Logistic regression analysis. Results: There were significant differences of Hb, Alb and BDNF among the three groups (P< 0.05), and there were significant differences of PA, SCr, BUN and Ca between the poor psychological function group and the healthy group (P< 0.05). There was a significant difference of BUN between the good psychological function groupand the healthy group (P< 0.05), but there was no significant difference in TP among the three groups (P> 0.05).The SCL-90 score of poor psychological function group was higher than that of the good psychological function group and the healthy group, with significant differences between groups (P< 0.01).Hb, Alb and BDNF were independent factors influencing the psychological function in patients undergoing maintenance hemodialysis(P< 0.05). Conclusion: There are great differences in biochemical indexes and psychological functionbetween patients undergoing maintenance hemodialysisand healthy people. Hb, Alb and BDNF are important factors influencing the psychological function in patients undergoing maintenance hemodialysis, and relevant indicators should be monitored in clinical practice.

Key words： Maintenance hemodialysis Biochemical index Psychological function Correlation Influencing factors

基金资助:湖北省卫生厅科研项目,(编号:13093654)

引用本文:

何俊. 维持性血液透析患者生化指标与心理功能的相关性及影响因素[J]. 河北医学, 2018, 24(3): 520-524.
HE Jun. Correlation and Influencing Factors of Biochemical iIndex and Psychological Function in Maintenance Hemodialysis Patients. HeBei Med, 2018, 24(3): 520-524.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.03.047 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I3/520

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