摘要
目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者焦虑状态和血清游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))的关系。方法单中心横断面研究。纳入2021年9月在暨南大学附属广州红十字会医院血液净化中心行MHD的患者。收集受试者的人口学、临床资料和问卷资料,测定透析前血常规、血清生化指标和血清FT_(3),根据汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分将患者分为非焦虑状态组(总分<7分)和焦虑状态组(总分≥7分),比较2组的临床特征,应用二元Logistic回归评价与MHD患者焦虑状态相关的因素,使用易侕(empower stats 3.0)软件分析变量间的因果中介效应。结果共纳入120例MHD患者,其中焦虑状态组66例,非焦虑状态组54例,spearman相关分析提示血清FT_(3)水平与睡眠评分呈负相关(r=-0.277,P=0.002)。在校正相关混杂因素后,多因素二元Logistic回归显示血清低FT_(3)水平和焦虑状态相关(OR=3.167,95%CI:1.144~8.772,P=0.027);将睡眠评分纳入时,FT_(3)和焦虑状态的独立关联消失(OR=0.842,95%CI:0.812~8.051,P=0.109)。中介效应分析显示血清FT_(3)和焦虑状态的关联中,有47.6%的效应占比是通过睡眠的变化达成的(P=0.004)。结论MHD患者血清FT_(3)水平与睡眠质量、焦虑三者之间存在密切联系,在血清FT_(3)和焦虑状态的关联中,有47.6%的效应是通过睡眠的变化达成的。
Objective To investigate the relationship between serum FT_(3) level and anxiety state in maintenance hemodialysis(MHD)patients.Methods This was a single-center and cross-sectional study.Patients who underwent MHD in our center in September 2021 were enrolled.Demographic data,routine blood biochemical examination,and serum free triiodothyronine(FT_(3))before dialysis sessions were tested,and the anxiety status of the patients was evaluated by the Hamilton Anxiety Scale(HAMA).According to the anxiety scale score,patients were divided into the without anxiety status group(total score<7 points)and with anxiety status group(total score≥7 points).Multivariate binary Logistic regression was used to analyze the independent factors associated with anxiety risk,and software(Empower Stats 3.0)was used to analyze causal mediating effects among variables.Results A total of 120 MHD patients were enrolled in this study,including 66 patients in the anxiety status group and 54 patients in the control group.Spearman analyses showed that the levels of serum FT_(3) negatively correlated with the sleep score(r=-0.277,P=0.002).Multivariate binary logistic regression analysis showed that low serum FT_(3) level in MHD patients in our center was independent associated with anxiety status(OR=3.167,95%CI:1.144~8.772,P=0.027),but when sleep score was included in the models,the association between the serum FT_(3) and anxiety status disappeared(OR=0.842,95%CI:0.812~8.051,P=0.109).Mediation analysis showed that 47.6%of the effect of serum FT_(3) on anxiety state was mediated through sleep disturbance(P=0.004).
作者
李茂雪
隆沐阳
刘云
钟小仕
刘岩
LI Mao-xue;LONG Mu-yang;LIU Yun;ZHONG Xiao-shi;LIU Yan(Department of Medicine Science,Guizhou Medical University,Guiyang 550004,China;Department of Nephrology,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China;Department of Nephrology,The Central Hospital of Shaoyang,Shaoyang 422000,China)
出处
《中国血液净化》
CSCD
2023年第6期410-414,共5页
Chinese Journal of Blood Purification
