终末期肾病患者抑郁程度与生存质量各个维度之间的关系

目的：分析终末期肾病患者抑郁发生的影响因素，探讨抑郁对患者生存质量的影响。方法：选择已确诊为终末期肾病患者186例，根据BECK抑郁调查表将患者分为抑郁者和非抑郁者，收集患者的一般资料，进行肾脏病生存质量量表(KDQOL-SFT)调查，并对结果进行分析。结果：186例终末期肾病患者发生抑郁者138 例（74.2%）。其中临界抑郁者26例、中度抑郁者72例、重度抑郁者37例、极端抑郁者3例。终末期肾病患者抑郁症发病率与性别及有无配偶无关联（P>0.05）；与患者年龄、职业状态、文化程度、经济水平、透析时间和付费方式有关联（P<0.05）。终末期肾病患者的抑郁程度与肾病相关生存质量中肾病给生活带来的负担(BKD)、社会支持(SOS)、透析医护人员的鼓励(DSE)和患者满意度(PS)4个维度无关联（P>0.05）；与肾病相关生存质量与症状与不适、肾病对
日常生活的影响(EKD)、工作状态(WS)、认知功能(CF)、社交质量(QSI)、性功能(SexF)和睡眠7个维度有关联（P<0.05）。抑郁与一般
健康相关生存质量SF-36中与体能(PF)、体力所致工作和生活受限(RP)2个维度无关联(P>0.05)；抑郁与疼痛、总体健康状况(GH)、情感状况(EWB)、情感对工作和生活的影响(RE)、社会功能(SocF)、精力状况、一般健康状态和健康状态变化7个维度有关联（P<0.05）。结论：终末期肾病患者的
症状与不适、EKD、WS、CF、QSI、SexF、睡眠、疼痛、GH、EWB、RE、SocF、精力状况、一般健康状态和健康状态变化14个维度均
对终末期肾病患者抑郁的发生产生影响。

Relationship between depression degrees and dimensionalities of survival quality of patients with end-stage renal disease

Objective To analyze the effect factors of depression occurrence in patients with end-stage renal disease,and to elucidate the impact of depression on life quality of patients with end-stage renal disease.Methods 186 patients with end-stage renal disease were divided into depression and non-depression patients according to BECK depression questionary.Then the Kidney Disease Quality of Life Short Form(KDQOL-SF)of patients were measured and the results were analyzed.Results In all 186 patients,138(74.2%) were depressed,including 26 cases of marginal depression,72 cases of moderate depression,37 cases of severe depression and 3 cases of critical depression.The incidence of depression was not correlated with gender or marital status(P>0.05),but it was correlated with age,occupational status,educational level,economic status,duration of dialysis,and type of medicare(P<0.05).There were significant differences in symptom/problems,effects of kidney disease on daily life(EKD),work status(WS),cognitive function(CF),quality of social interaction(QSI),sexual function(SexF) and sleep between depression and non-depression patients(P<0.05),while there were no significant differences in burden of kindey disease(BKD),social support(SOS),dialysis staff encouragement(DSE) or patient satisfaction(PS) between two kinds of patients(P>0.05).Depression was correlated with pain,general health preperceptions(GH),emotion well-being(EUB),role linitations caused by emotional health problems(RE),social function(SocF),energy /fatigue,and changes in health(GH) and general health scales(P<0.05),but depression wasn't correlated with physical functioning(DF) or role limitations caused by physical health problems(RP)(P>0.05).Conclusion 14 dimensionalities of survival quality(symptom/ problems,EKD,WS,CF,QSI,SexF,sleep,pain,GH,EWB,RE,SocF,energy/fatigue,change in health and general health scales) are positively correlated with depression occurrence in patients with end-stage renal disease.