维持性血液透析病人抑郁状况及影响因素分析

    Analysis of the depression condition and related influencing factors inpatents with maintenance hemodialysis

    • 摘要:
      目的探讨维持性血液透析(maintenance hemodialysis,MHD)病人抑郁发生状况及其相关影响因素分析。
      方法选取219例接受血液透析的尿毒症病人作为研究对象,并择同期进行体检的健康人群261名作为对照组,采用抑郁自评量表(SDS)和一般状况调查问卷评估抑郁发生情况,同时检测疾病相关实验室指标并进行分析。
      结果MHD病人抑郁的发生率明显高于对照组(P < 0.01)。MHD病人的家庭收入、病程、并发症、社会支持等一般资料对SDS评分的影响均有统计学意义(P < 0.05~P < 0.01)。MHD病人中抑郁组血尿素氮、血肌酐、血磷、甲状旁腺激素(PTH)水平均高于非抑郁组(P < 0.05~P < 0.01);Pearson相关分析发现MHD病人血尿素氮、血肌酐、血磷、PTH水平与抑郁SDS评分呈正相关(P < 0.05~P < 0.01);家庭收入低、病程长、有并发症、缺乏社会支持的MHD病人更容易发生抑郁(P < 0.05~P < 0.01)。对有统计学意义的相关因素进行多元回归分析发现,家庭收入、社会支持、血磷水平、PTH水平是MHD病人发生抑郁的独立影响因素(P < 0.05~P < 0.01)。
      结论临床应重视MHD病人发生抑郁的相关影响因素,及早给予干预,减少抑郁的发生,提高生活质量。

       

      Abstract:
      ObjectiveTo investigate the depression condition and related influencing factors in patients with maintenance hemodialysis(MHD).
      MethodsA tolal of 219 uremic patients treated with hemodialysis were investigated, and 216 healthy people were set as the control.The depression condition was evaluated using the self-rating depression scale(SDS) made by W.K.Zuang and general condition questionnaire.The disease related laboratory indicators were detected and analyzed.
      ResultsThe incidence rate of the depression in MHD patients was significantly higher than that in control group.The differences of the effects of family income, course of illness, complications and social support on the SDS score in MHD patients were statistically significant(P < 0.05 to P < 0.01).Among MHD patients, the levels of blood urea nitrogen(BUN), serum creatinine(SCr), serum phosphorus and thyroid hormone(PTH) in depression group were higher than those in non-depression group(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the levels of BUN, SCr, blood phosphorus and PTH in patients were positively correlated with the SDS score of depression(P < 0.05 to P < 0.01).The MHD patients with low family income, long course of disease, complications and lack of social support were more likely to develop depression(P < 0.05 to P < 0.01).The results of multiple regression analysis of the significantly relevant factors showed that the family income, social support, blood phosphorus level and thyroid hormone level were the independent influencing factors of depression in MHD patients.
      ConclusionsThe related influencing factors of depression in MHD patients should be emphasized in clinic, the early intervention should be given to reduce the occurrence of depression, and improve the quality of life of patients.

       

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