慢性肾脏病4期以上焦虑和抑郁状态的动态变化

目的分析慢性肾脏病4期、血液透析和腹膜透析患者在1年随访中的焦虑和抑郁状态的变化及原因。方法选择在我科住院并随访的慢性肾脏病4期患者28例（慢性肾脏病4期组）、血液透析患者21例（血液透析组）、腹膜透析患者43例（腹膜透析组），用Hamilton焦虑和抑郁量表，在0个月（慢性肾脏病4期组在入院时、或血液透析组和腹膜透析组在初始进入透析）、6个月和12个月进行问卷调查。结果选择在我科住院并随访的慢性肾脏病4期患者28例（慢性肾脏病4期组）、血液透析患者21例（血液透析组）、腹膜透析患者43例（腹膜透析组），用Hamilton焦虑和抑郁量表，在0个月（慢性肾脏病4期组在入院时、或血液透析组和腹膜透析组在初始进入透析）、6个月和12个月进行问卷调查。结果0个月时，Hamilton焦虑和抑郁指数腹膜透析组最高，血液透析组次之，慢性肾脏病4期组患者较轻（P〈0．05）。6个月后，血液透析组的心理问题最重（P〈O．05），慢性肾脏病4期组和腹膜透析组较轻。12个月后，慢性肾脏病4期组的心理问题较严重，血液透析组次之，腹膜透析组较轻（P〈0．05）。结论慢性肾脏病4期和透析患者焦虑抑郁的发生率较高，其中透析患者更高。随着时间的推移，患者在各时问段的心理状态有一定的变化。

Anxiety and depression in patients with stage 4 chronic kidney diseases and uremic patients underdoing hemodialysis or peritoneal dialysis during different stage

Objective We aimed to observe the change of anxiety and depression conditions in patients with stage 4 chronic kidney diseases and uremic patients underdoing hemodialysis or peritoneal dialysis during the first one year. Methods Patients were divided into three groups： chronic kidney dis- ease （CKD4） （n = 28）, uremic patients underdoing hemodialysis（HD） （n = 21 ） and peritoneal dialysis （PD） （n = 43）. The Hamilton anxiety/depression scale was repeatedly measured at baseline and six month and one year after starting dialysis. Results The anxiety scale and depression scale in PD group were the highest during three groups, and that were significantly higher in HD groups than that in CKD4 groups at baseline （P〈0. 05）. The anxiety scale and depression scale were the highest in HD groups than that in CKD4 groups and PD groups （P〈0. 05）after six months. H0wever,after one year, the scales were higher in CKD4 groups than in HD groups, and that were higher in HD groups than in PD groups （P〈0. 05）. Conclusions The status of anxiety and depression were higher among chronic kidney disease, hemodialysis and peritoneal dialysis patients, and there were differences at baseline and during one year on psychological state.