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维持性血液透析患者抑郁与微炎症、血锌和营养不良的相关性研究

Association of depression with microinflammation, serum zinc level, and malnutrition in maintenance hemodialysis patients

摘要:

目的 探讨维持性血液透析(MHD)患者抑郁与微炎症、血锌和营养不良的关系.方法 157例MHD患者以贝克抑郁量表(BDI)评分为标准分为非抑郁组和抑郁组.比较两组患者社会因素、相关生化指标、血锌、营养不良炎症(MIS)评分和并发症(IPI)评分差异.应用二项logistic回归方程分析与抑郁发生相关的危险因素.结果 157例患者,非抑郁组86例,抑郁组71例,抑郁发生率为45.2% (71/157),中重度抑郁发生率为24.2%( 38/157).非抑郁组与抑郁组年龄[(50±13)比(62±11)岁]、MIS评分[(3.3±1.6)比(7.2±2.2)分]、WBC[(5.8±1.5)×109/L比(6.4±1.8)×109/L]、超敏CRP[(4±4)比(9±6)mg/L]、Hb[(11.3±1.5)比(10.7±1.5)g/L]、白蛋白[(37±3)比(33±4) g/L]、血糖[(5.6±2.1)比(6.7±3.5) mmol/L]、血锌[(10.1±2.9)比(8.5±2.6)μmol/L]、全段甲状旁腺激素[(437±459)比(300±352) ng/L]差异有统计学意义(均P<0.05).二项logistic回归分析显示,MIS评分(OR=2.908,95% CI =2.037~4.151)、血锌(OR=0.942,95%CI=0.907~0.979)、超敏CRP( OR=1.217,95% CI=1.075~1.370)、血糖(0R=1.315,95%CI=1.039~1.664)均为抑郁发生的独立危险因素.结论 MHD患者抑郁发生率高,抑郁与微炎症、血锌和营养不良密切相关,MIS评分、血锌、超敏CRP、血糖为抑郁发生的独立危险因素.

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Objective To investigate the prevalence of depression in maintenance hemodialysis (MHD) patients. Additionally,to explore the relationship between depression and microinflammation,serum zinc levels and malnutrition in MHI) patients.Methods One hundred fifty-seven MHD patients were enrolled in this study.The patients were divided into two groups:depressed patients and non-depressed patients,according to the Beck Depression Inventory.The following data were collected:social factors,biochemical index,serum zinc levels,malnutrition-inflammation (MIS) score and IPI score.Binary logistic regression analysis was performed.Results Symptoms of depression were exhibited by 45.2% of MHD patients (71/157 ).Symptoms of moderate or severe depression were exhibited by 24.2 % of the patients ( 38/157 ).However,signicant differences were shown in age [( 62 ± 11 ) vs.( 50 ± 13 ) years old],MIS score [( 7.2 ± 2.2 ) vs.( 3.3 ± 1.6 ) scores],white blood cell count [( 6.4 ± 1.8 ) × 109/L vs.( 5.8 ±1.5) × 109/L],high sensitivity C-reactive protein (hsCRP) [(9 ±6) vs.(4 ±4) mg/L],hemoglobin [(10.7±1.5) vs.(11.3±1.5) g/L],albumin[(33±4) vs.(37 ±3) g/L],fasting glucose [(6.7±3.5) vs.(5.6±2.1) mmol/L],serum zinc [(8.5±2.6) vs.(10.1 ±2.9) μmol/L] between depressed patients and non-depressed patients ( All P < 0.05 ). Binary logistic regressive analysis revealed that the independent risk factors of depression in MHD patients were their MIS score ( OR =2.908,95% CI =2.037 -4.151 ),as well as their hsCRP( OR =1.217,95% CI=1.075 - 1.370),serum zinc and fasting glucose levels(OR=1.315,95%CI=1.039 - 1.664).Conclusions There was a high prevalence of depression in MHD patients.Depression is also highly correlated with microinflammation,serum zinc levels,and malnutrition.MIS scores,hsCRP,serum zinc levels and fasting glucose levels.

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作者: 张春华 [1] 申珅 [1] 王世相 [1]
分类号: R459.5
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1671-7368.2012.05.016
发布时间: 2012-07-23
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