摘要
目的探讨尿毒症患者首次血液透析前后抑郁的状况及其影响因素。方法应用汉密尔顿抑郁量表和自制一般资料调查表对177例尿毒症患者进行问卷调查,同时检测患者实验室指标并进行分析。结果透析前1周35.0%的患者有不同程度抑郁症状,透析后1周11.9%的患者有抑郁症状;透析前后抑郁评分分别为(14.96±8.37)、(6.52±3.81)分,差异有统计学意义(t=16.267,P<0.01)。有合并症与无合并症患者抑郁评分,差异有统计学意义(t=-2.528,P=0.013);而患者不同性别、年龄、文化程度、原发病种类,是否吸烟、饮酒的抑郁评分差异无统计学意义(P>0.05)。3组研究对象血肌酐(Cr)、血尿素氮(BUN)、空腹血糖(GLU)、清蛋白(Alb)、总胆固醇(TC)水平,差异有统计学意义(P<0.01)。Spearman相关分析显示,GLU、Cr、BUN的水平与抑郁评分呈正相关,TC、Alb水平与抑郁评分呈负相关,差异有统计学意义(P<0.01)。结论应重视对血液透析患者抑郁状况的评估。
Objective To investigate the depression status and its influencing factors in the patients with uremia before and after the first time hemodialysis.Methods A total of 177 patients with uremia conducted the questionnaire investigation by using the Hamilton Depression Scale and self-made general information questionnaire.Meanwhile,the laboratory indexes were detected and analyzed.Results At one week before dialysis,35% of the patients had different degrees of depression symptoms,11.9% of the patients had depressive symptoms at 1 week after dialysis;the depression scores before and after dialysis were(14.96±8.37)points and(6.52±3.81)points respectively,the difference was statistically significant(t=16.267,P<0.01).The depression score had statistical difference between the patients with complications and patients without complications(t=-2.528,P=0.013);while the depression scores had no statistical difference among the patients with different sexes,ages,cultural levels,types of original diseases,whether smoking and drinking(P<0.01).The Spearman correlation analysis showed that the levels of GLU,Cr and BUN were positively correlated with the depression score,while the levels of TC and Alb were negatively correlated with the depression score,the difference was statistically significant(P<0.01).Conclusion The evaluation of depression status in hemodialysis patients should be emphasized.
引文
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