摘要
目的探讨血液透析患者认知功能变化的特征以及认知功能变化的风险因素。方法采集血液透析患者基线资料以及2次蒙特利尔认知评估量表(MoCA)测试结果,分析患者2年期间认知功能变化的特征并采用多元线性回归分析认知功能变化的风险因素。结果103例患者纳入研究,其中认知功能障碍69例(67.0%),认知功能障碍组的年龄、透析龄、卒中以及心脏病患病比例均高于认知功能正常组,血红蛋白、受教育程度以及MoCA评分均低于正常组(P<0.05)。2年后患者MoCA、视空间与执行功能以及延迟回忆得分均低于2年前(P<0.05)。多元线性回归结果显示,MoCA变化量受年龄、受教育程度、心脏病史以及透析龄影响;视空间与执行功能变化量受年龄、受教育程度以及心脏病史影响;延迟回忆变化量受年龄、受教育程度以及透析龄影响(均P<0.05)。结论血液透析患者认知功能随着时间延长呈现显著下降趋势,主要是视空间与执行功能和延迟回忆功能下降。高龄、受教育程度低、心脏病史以及透析龄长是此类患者认知功能下降的风险因素。
Objective To analyze the characteristics of cognitive function changes and its associated risk factors in hemodialysis patients. Methods Baseline data of hemodialysis patients and the results of two Montreal Cognitive Assessment Scale (MoCA) tests were collected. The characteristics of cognitive function changes in patients in two years were analyzed, and the associated risk factors of cognitive function changes were analyzed by multiple linear regression method. Results A total of 103 patients were included in the study (67.0%). It was found that age, dialysis age and the prevalence rates of stroke and heart disease were higher in cognitive impairment group than those in normal group. And hemoglobin level, education and the scores of MoCA were significantly lower in cognitive impairment group than those in normal group (P<0.05). After two years, the scores of MoCA, visual space, executive function and delayed recall were significantly lower than those of baseline (P<0.05). Multivariate linear regression analysis showed that changes of MoCA were affected by age, education level, history of heart disease and dialysis age;changes of visual space and executive function were affected by age, education level and history of heart disease;and changes of delayed recall were affected by age, education level and dialysis age (all P<0.05). Conclusion Cognitive function shows a significant downward trend during a two-year period in hemodialysis patients, which are mainly in the area of visual space, executive function and delayed recall. Older age, lower education, history of heart disease and longer dialysis age are risk factors for cognitive decline in these patients.
作者
田茹
郭一丹
罗洋
TIAN Ru;GUO Yi-dan;LUO Yang(Department of Nephrology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《天津医药》
CAS
北大核心
2019年第7期723-726,共4页
Tianjin Medical Journal
基金
北京市科学技术委员会国家重大研发匹配基金(Z161100002616005)
关键词
肾透析
认知功能障碍
危险因素
血液透析
renal dialysis
cognitive dysfunction
risk factors
hemodialysis
