尿毒症患者肾移植前后抑郁水平调查

目的:通过对尿毒症患者肾移植前后抑郁水平作一临床对比研究,并对与抑郁水平相关的影响因素作一分析,探讨减少尿毒症患者抑郁发生和提高其生活质量的有效方法.方法:选择于2005-01/2008-12在河南中医学院第一附属医院诊断为尿毒症的患者91例,分为3组,肾移植后移植肾功能正常组28例;等待肾移植组31例;肾移植术后出现慢性排斥反应而恢复血液透析组32例.采用Beck抑郁量表对患者进行问卷调查,包括患者的年龄、性别、婚姻状况、尿毒症病程、肾移植后慢性排斥反应发生率、移植肾功能维持正常时间和透析时间等指标.观察抑郁发生率,并做抑郁水平相关因素分析.结果:①肾功正常组患者抑郁水平明显低于血液透析组(P＜0.01);待移植组患者抑郁水平低于血液透析组(P＜0.05).②抑郁的发生与患者的年龄和性别无明显关联(P＞0.05);已婚患者抑郁的发生率和水平低于单身患者(P＜0.05);血液透析组患者抑郁水平与移植肾功能维持正常时间的长短呈负相关(r=-0.34,P＜0.05).结论:对于单身的尿毒症患者和肾移植后移植肾功能衰竭而重新血液透析的患者,给予更多的社会和心理支持是很有必要的.把更多的尿毒症患者纳入肾移植等待范围能减少抑郁的发生,减轻抑郁的发生程度,从而提岛患者的生活质量和透析效果.

Depression levels of uremia patients before and after renal transplantation

OBJECTIVE:To investigate effective methods of decreasing the incidence of depression and improving quality of life on uremia patients by comparing the depression levels and influential factors before and after renal transplantation.METHODS:A total of 91 uremia patients admitted to First Affiliated Hospital of Henan College of Traditional Chinese Medicine between January 2005 and December 2008 were selected and divided into three groups:renal transplant recipients(n=28)with normal renal function;patients waiting for renal transplant(n=31);and chronic allograft rejection patients on hemodialysis therapy(n=32).Depression levels were evaluated by the Beck Depression Inventory,including age,sex,marriage,uremia course,incidence of chronic rejection,time of maintaining normal renal function as well as hemodialysis time.In addition,incidence of depression and related factor analysis were investigated.RESULTS:The depression level of the renal transplant recipients was significantly lower than hemodialysis patients with chronic allograft rejection(P＜0.01),and patients waiting for renal transplant was lower than hemodialysis patients(P＜0.05).The presence of depression was not related to age or gender(P＞0.05).Married patients showed a lower percentage of depression (P＜0.05).There was a negative correlation between depression and functional graft duration among patients with transplant failure(r=-0.34,P＜0.05).CONCLUSION:Single patients and transplant failure patients who returned to hemodialysis therapy need more social and psychologic supports.Uremia patients should be included in transplant waiting lists,which could decrease depression and may improve their quality of life and obtain better outcome during hemodialysis therapy.