摘要
目的:研究糖尿病肾病腹膜透析患者的心理状况及与腹透相关因素的关系,为患者心理康复提供依据。方法:2001/2003年在解放军沈阳军区总医院肾内科门诊及住院的腹膜透析患者148例。纳入标准:经检查确诊为糖尿病肾病,并需进行持续性非卧床式腹膜透析患者。排除标准:排除有广泛腹膜粘连,腹腔内脏外伤,腹部大手术早期患者。入选对象根据配对条件:年龄相差不超过5岁;同性别,同民族进行1∶1配对,将64例患者分为两组:糖尿病肾病组32例,非糖尿病肾病组32例。使用焦虑自评量表和抑郁自评量表分别评估患者的情绪状况,并测定患者的营养状况、残余肾功能和透析的充分性等指标。结果:糖尿病肾病腹透组患者焦虑和抑郁检出率分别为56%和66%均高于非糖尿病的肾病腹透患者焦虑和抑郁检出率34%和47%(χ2=5.14,4.17,P<0.05)。营养不良患者焦虑评分和抑郁评分均高于营养良好者(t=3.93,4.10,P<0.01)。血清白蛋白、标准化氮出现率相当蛋白、平均每日每公斤体质量的蛋白质摄入量、尿素清除指数和肌酐清除率等指标与糖尿病肾病腹透组患者焦虑评分及抑郁评分呈明显负相关(r=-0.4289,-0.3645,-0.4594,-0.3663-0.3491,P<0.05～0.01;r=-0.4304,-0.3926,-0.4895-0.3665,-0.3720,P<0.05～0.01),而平均每日每公斤体质量的热量与焦虑评分、
AIM: To study the psychological status and its correlative relations with peritoneal dialysis for diabetic nephropathy (DN) patients and provide evidence for the psychological rehabilitation in patients.METHODS: Totally 148 patients for peritoneal dialysis hospitalizing in the Department of Nephrology, General Hospital of Shenyang Military Area Command of Chinese PLA from 2001 to 2003 were selected. Inclusive criteria: having DN and being given lasting nonlying peritoneal dialysis. Exclusive criteria: vast peritoneal adhesion, injury on abdominal viscera and in the early period of abdominal operation.Subjects were matched according to the criteria that less than 5 years' gap, and 1∶1 in people with the same sex and nationality. The 64 patients were divided into two groups: DN group (n=32) and non DN group (n=32).The self rating anxiety scale (SAS) and self rating depression scale (SDS) made by ZUNG were used to evaluate the emotional status of patients, nutritional status, remaining kidney function and the sufficiency of dialysis.RESULTS: The rates of anxiety and depression of DN patients were 56%and 66%respectively, which were higher than those of non DN patients (34%and 47%) (χ2=5.14, 4.17, P< 0.05). The scores of anxiety and depression in malnutrition patients was higher than those in good nutritious patients (t=3.93, 4.10,P< 0.01). Serum albumin (ALB), normalized protein equivalent of nitrogen appearance rate(nPNA), daily protein input (DPI), urea clearness index(UCI) and creatinine clearness rate (CCR) were negatively correlated with the scores of anxiety and depression in DN patients (r=-0.428 9,-0.364 5, -0.459 4,-0.366 3,-0.349 1,P< 0.05-0.01;r=-0.430 4, -0.392 6, -0.489 5,-0.366 5, -0.372 0,P< 0.05 to 0.01), while calories of body mass (kg per day) was not correlated with the scores of anxiety and depression (r=-0.243 4,-0.270 3,P >0.05).CONCLUSION: The morbidity of anxiety and depression in ND patients after peritoneal dialysis is higher, which is correlated with malnutrition. The anxiety and depression are related to sex, stress factors and duration of illness.
出处
《中国临床康复》
CSCD
北大核心
2005年第12期68-70,共3页
Chinese Journal of Clinical Rehabilitation
