| 摘要 |
[摘要]探讨基于尿素动力学模型（ureakineticmodel,UKM）评估维持性血液透析（Maintenance hemodialysis,MHD）患者透析充分性与患者焦虑和抑郁之间的关联性分析。方法 回顾性分析2021年6月~2022年6月收治的64例MHD患者的临床资料，通过UKM模型评估患者透析充分性，并以此为依据将患者分为透析充分组（44例）、透析不充分组（20例），比较两组UKM参数[时间平均尿素浓度（Time-average Concentration of urea ，TACurea）、整体尿素清除率（urea clearance index,KT/V）、蛋白质分解代谢率（Protein catabolism rate，PCR）]；采用ROC曲线得出UKM参数界值，比较不同UKM参数水平患者焦虑自评量表评分（SAS）、抑郁自评量表评分（SDS）水平，采用Spearman相关分析UKM参数与SAS、SDS评分相关性。结果 透析充分组TACurea、PCR值均明显大于透析不充分组（t=20.406、5.390，P<0.05）；两组KT/V值比较无差异（P>0.05）。通过ROC曲线分析可知，TACurea界值为16.23 mmol/L、PCR界值为0.61 g/kg-1·d-1。TACurea≥16.23 mmol/L组患者SAS、SDS评分均明显低于TACurea<16.23 mmol/L组患者（t=3.222、5.209，P<0.05）；PCR≥0.61 g/kg-1·d-1组患者SAS、SDS评分均明显低于PCR<0.61 g/kg-1·d-1组患者（t=5.043 、3.443，P<0.05）。Spearman相关分析显示，TACurea、PCR与SAS、SDS评分均呈显著负相关（r=-0.367、-0.563，-0.560、-0.410，P<0.01）。结论 基于UKM模型可准确评估MHD患者透析充分性，且其透析充分性与患者焦虑和抑郁之间存在存在明显关联，患者透析越充分焦虑抑郁水平越低。
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| Abstract |
[Abstract]Objective To investigate the relationship between dialysis adequacy and anxiety and depression in maintenance hemodialysis (Maintenance hemodialysis,MHD) patients based on urea dynamics model (ureakineticmodel,UKM).Method The clinical data of 64 MHD patients admitted from June 2021 to June 2022 were retrospectively analyzed. The dialysis adequacy of patients was evaluated by UKM model, and the patients were divided into adequate dialysis group (44 cases) and inadequate dialysis group (20 cases). UKM parameters [Time-average Concentration of urea (Time-average Concentration of urea ，TACurea), overall urea clearance (urea clearance index,KT/V), protein catabolic rate (Protein catabolism rate，PCR)] were compared between the two groups. The boundary values of UKM parameters were obtained by ROC curve. The levels of self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS) of patients with different UKM parameters were compared, and the correlation between UKM parameters and SAS and SDS scores was analyzed by Pearson correlation analysis.Result The TACurea and PCR values in adequate dialysis group were significantly higher than those in inadequate dialysis group (t=20.406, 5.390, P<0.05). There was no difference in KT/V between the two groups (P>0.05). ROC curve analysis showed that the limit value of TACurea was 16.23 mmol/L and the limit value of PCR was 0.61 g/kg-1·d-1. The scores of SAS and SDS of TACurea≥16.23 mmol/L group were significantly lower than those of TACurea<16.23 mmol/L group (t=3.222, 5.209, P<0.05). The scores of SAS and SDS in PCR≥0.61 g/kg-1·d-1 group were significantly lower than those in PCR<0.61 g/kg-1·d-1 group (t=5.043, 3.443, P<0.05). Spearman correlation analysis showed that TACurea and PCR were significantly negatively correlated with SAS and SDS scores (r=-0.367, -0.563, -0.560, -0.410, P<0.01).Conclusion The UKM model can accurately assess the dialysis adequacy of MHD patients, and there is a significant correlation between dialysis adequacy and anxiety and depression. The more fully dialysis patients have, the lower the anxiety and depression level.
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