维持性血液透析患者抑郁及焦虑障碍的相关因素分析

目的：了解维持性血液透析患者抑郁及焦虑障碍的发病率及影响因素。方法：选取2012年1月至2012年4月在广州中医药大学附属第一医院肾内科血液透析中心维持性血液透析患者95例，使用Zung抑郁自评量表、焦虑自评量表进行调查，并记录患者的一般情况及实验室指标，分析患者抑郁及焦虑障碍的发病率：评估一般情况及实验室指标与抑郁及焦虑障碍发生的相关性。结果：95例患者中有65．3％的患者存在抑郁障碍，有67．4％的患者存在焦虑障碍，同时存在抑郁及焦虑障碍的有36．8％。抑郁障碍患者焦虑障碍发病率较低（P〈0．05），焦虑障碍患者抑郁障碍发病率较低（P〈0．05）。发生抑郁障碍患者中，女性多于男性（P〈0．05），随着年龄增加，抑郁程度逐渐增加（r=25．849，r=0．485，P〈0．05）。未发生抑郁障碍的患者SAS得分高（P〈0．05）。发生抑郁障碍的患者SDS得分与SAS得分有明显相关性（r=0．393，P〈0．05），而焦虑障碍患者SDS得分与SAS得分无明显相关性。结论：维持性血液透析患者中抑郁和焦虑障碍的发病率较高．其中抑郁障碍女性多发，年龄越大。抑郁程度越高。

Depression and anxiety disorder and associated factors in patients treated with maintenance hemodialysis

Objective：To study the prevalence and associated factors of depression and anxiety disorder in patients receiving maintenance hemodialysis （MHD）. Methods： Ninety-five patients who were treated with MHD in the department of hemodialysis, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, between January and April 2012, were recruited. The prevalence of depression and anxiety disorder were assessed by Zung＇ s self-rating depression scale （SDS）, anxiety scale （SAS）, general conditions and laboratory testing. This entailed subsequent determination of the correlation between general conditions, laboratory testing and the prevalence of depression and anxiety disorder. Results： Of 95 patients enrolled, 62 （65.3%） were identified as having depression disorder, 64 （67.4%） anxiety disorder, and 34 （36.8%） both. Patients with depression presented a lower incidence of anxiety （ P 〈 0.05 ）, and the vice versa （ P 〈 0. 05）. Females were linked to a higher incidence of depression （ P 〈 0.05 ）, and aging was associated with increased severity of depression （X2 = 25. 849, r = 0. 485, P 〈 0.05 ）. A higher SAS score was noted in patients without depression （ P 〈 0.05 ）. The SAS scores were correlated with SDS scores in patients with depression （ r = 0. 393, P 〈 0.05 ）, but not in those with anxiety（ P 〉 0. 05 ）. Conclusion ： Patients receiving MHD, particularly the females, are more likely to develop depression and anxiety. Aging contributes to increased severity of depression.