腹膜透析病人的焦虑和抑郁水平与其病情变化的相关分析

目的:探讨腹膜透析病人情绪障碍,即焦虑症状和抑郁症状的发生情况,以及与透析相关因素的关系.方法:88例腹膜透析病人,使用Hamilton焦虑量表和Hamilton抑郁量表评估其情绪状况,同时测定其营养状况、残余肾功能和透析充分性、以及炎症水平,记录心脑血管事件发生情况等.结果:本组腹膜透析病人焦虑症状的发生率为44.3%,抑郁症状的发生率为56.8%.具有糖尿病和心脑血管病史者的Hamilton焦虑评分和抑郁评分高于无此类病史者(P<0.05).SGA评分较高的病人Hamilton焦虑评分和抑郁评分也较高;焦虑评分和抑郁评分较高的病人,其血清白蛋白水平、蛋白质摄入水平、体重指数、上臂中段肌肉面积和脂肪面积均较低(r=0.22～0.60,P<0.05或P<0.01).结论:腹膜透析病人焦虑症状和抑郁症状的发生率较高,焦虑症状和抑郁症状与心脑血管系统疾病和糖尿病相关,并可能与营养不良的发生存在一定的关系.

Anxiety and Depression of Patients in Peritoneal Dialysis

Objective:To find the rate of anxiety and depression in peritoneal dialysis (PD) patients,and the relationship between these emotion disorder and PD processes.Method:88 PD patients were studied, their mood state was evaluated with Hamilton Anxiety Scale and Hamilton Depression Scale. Nutritional indexes, residual renal function and dialysis adequacy, and inflammation status were also recorded as well as history of cardiac-cerebral vascular disease. These patients were followed for 2 years.Result:44.3% patients were detected as anxiety, and 56.8% depression. Higher SGA was associated with higher Hamilton anxiety/depression scale. Patients with higher anxiety and higher depression had lower serum albumin, lower protein intake, lower body index, and lower mid-arm muscle area and fat area. Anxiety and depression is related to cardiac-cerebral vascular diseases and diabetes.There was no significant relationship between Hamilton anxiety/depression score and patient's survival.Conclusion:There is a high rates of anxiety and depression in PD patients and it may be a potential risk factor of malnutrition.