长期透析低氧与维持性血液透析患者临床预后和负性情绪的相关性分析

Correlation analysis between clinical prognosis and negative emotion in patients with long-term dialysis hypoxia and maintenance hemodialysis

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2020, 47(1)
作者
作者单位

郑州市第七人民医院肾内科 ;

摘要
探讨长期透析低氧(PIH)与维持性血液透析(MHD)患者临床预后和负性情绪的相关性。方法 前瞻性纳入在2016年10月~2016年12月212例行规律血液透析的ESRD患者。将SaO2 ≤90 %的时间大于总治疗时间的1/3作为PIH的诊断标准,分为PIH组(n=144)与非PIH组(n=68)。再按照是否间断给予患者2L/min吸氧将患者分为PIH氧疗组(n=80)与PIH非氧疗组(n=64)。统计临床资料并随访2年,分析PIH与MHD患者临床预后的关系,并分析PIH与MHD患者负性情绪的关系。结果 PIH组和非PIH组吸烟、心脑血管疾病和NT-proBNP比较存在显著性差异(P<0.05),其他指标比较差异均无统计学意义(P>0.05)。Logistic回归分析结果显示吸烟、心脑血管疾病和NT-proBNP是MDH患者PIH发生的独立影响因素(P<0.05)。随访期间,212例患者中48例患者发生心血管事件,70例患者住院、共死亡病例56例(死因为心血管疾病、脑血管意外、感染和多脏器功能衰竭)。PIH组心血管事件发生率、住院率和死亡率均显著高于非PIH组(P<0.05);PIH非氧疗组心血管事件发生率、住院率和死亡率均显著高于PIH氧疗组(P<0.05)。PIH组与非PIH组,PIH非氧疗组与PIH氧疗组生存分析分别见图1和图2,比较均存在显著性差异(P<0.05)。PIH组SAS评分和SDS评分均高于非PIH组(P<0.05);PIH氧疗组SAS评分和SDS评分均高于非PIH氧疗组(P<0.05)。结论 MHD患者PIH发生率较高,可显著增加心血管事件发生率、住院率和死亡率,适度氧疗有助于降低PIH带来的不良影响,但可能会加重焦虑、抑郁等负性情绪。
Abstract
Objective To investigate the correlation between long-term dialysis hypoxia (PIH) and maintenance hemodialysis (MHD) patients with clinical prognosis and negative emotions. METHODS: We prospectively included 212 ESRD patients who had regular hemodialysis between October 2016 and December 2016. SaO2 ≤ 90% of the time is greater than 1/3 of the total treatment time as the diagnostic criteria of PIH, divided into PIH group (n = 144) and non-PIH group (n = 68). Then according to whether or not to intermittently give patients 2L/min oxygen, the patients were divided into PIH oxygen therapy group (n=80) and PIH non-oxygen therapy group (n=64). Clinical data were collected and followed up for 2 years to analyze the relationship between PIH and clinical prognosis of MHD patients, and analyze the relationship between PIH and negative emotions in patients with MHD. Results There were significant differences in smoking, cardiovascular and cerebrovascular diseases and NT-proBNP between PIH and non-PIH groups (P<0.05). There was no significant difference in other indicators (P>0.05). Logistic regression analysis showed that smoking, cardiovascular and cerebrovascular diseases and NT-proBNP were independent factors in the occurrence of PIH in MDH patients (P<0.05). During the follow-up period, cardiovascular events occurred in 48 of 212 patients, and 56 patients were hospitalized and died in 56 cases (death due to cardiovascular disease, cerebrovascular accident, infection, and multiple organ failure). The incidence of cardiovascular events, hospitalization, and mortality were significantly higher in the PIH group than in the non-PIH group (P<0.05). The incidence of cardiovascular events, hospitalization, and mortality were significantly higher in the PIH non-oxygen therapy group than in the PIH oxygen therapy group. (P<0.05). The survival analysis of PIH group and non-PIH group, PIH non-oxygen therapy group and PIH oxygen therapy group are shown in Figure 1 and Figure 2, respectively, there are significant differences (P <0.05). The SAS score and SDS score of PIH group were higher than those of non-PIH group (P<0.05). The SAS score and SDS score of PIH oxygen therapy group were higher than those of non-PIH oxygen therapy group (P<0.05).Conclusion The incidence of PIH in patients with MHD is high, which can significantly increase the incidence of cardiovascular events, hospitalization and mortality. Moderate oxygen therapy can help reduce the adverse effects of PIH, but it may aggravate negative emotions such as anxiety and depression.
关键词
终末期肾病;维持性血液透析;长期透析低氧;预后;负性情绪
KeyWord
End-stage renal disease; Maintenance hemodialysis; Long-term dialysis Hypoxia; Prognosis; Negative emotion
基金项目
页码 148-151
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张靖华*. 长期透析低氧与维持性血液透析患者临床预后和负性情绪的相关性分析 [J]. 国际精神病学杂志. 2020; 47; (1). 148 - 151.

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