[1]吴静,邓志宽,赵景宏,等.慢性肾病对患者认知功能的影响及其相关因素的初步研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(15):1773-1776.
 Wu Jing,Deng Zhikuan,Zhao Jinghong,et al.Impact of chronic kidney disease on patients’ cognitive function and its related factors: a preliminary study[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(15):1773-1776.
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慢性肾病对患者认知功能的影响及其相关因素的初步研究(/HTML )
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陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第15期
页码:
1773-1776
栏目:
临床医学
出版日期:
2016-08-15

文章信息/Info

Title:
Impact of chronic kidney disease on patients’ cognitive function and its related factors: a preliminary study
作者:
吴静邓志宽赵景宏黄云剑冯兵
第三军医大学新桥医院:肾内科,神经内科
Author(s):
Wu Jing Deng Zhikuan Zhao Jinghong Huang YunjianFeng Bing

Department of Nephrology, Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China

关键词:
慢性肾病认知障碍尿酸血红蛋白
Keywords:
chronic kidney disease cognitive impairment uric acid hemoglobin
分类号:
R181.32; R692.06; R741
文献标志码:
A
摘要:

目的      探讨慢性肾病(chronic kidney disease,CKD)对患者认知功能的影响及其相关因素。      方法      选择2014年6月至2015年6月在本院肾内科门诊就诊或住院,年龄>18岁,诊断为慢性肾病3~5期的患者266例,根据估计肾小球滤过率(estimated glomerular filtration rate,eGFR)水平分别纳入3期CKD(CKD3)组(60 mL/min>eGFR≥30 mL/min,92例)、4期CKD(CKD4)组(30 mL/min>eGFR≥15 mL/min,96例)和5期CKD(CKD5)组(EGFR<15 mL/min,78例)。选择年龄、性别及教育程度相匹配的、eGFR>90 mL/min、外观基本正常的人群80例作为对照组。应用简易智力状况检查法(mini-mental state examination, MMSE)检测患者智能状态;应用OLYMPUS AU2700 全自动生化分析仪测定血清肌酐(Cr)、尿素氮(UN)、尿酸(UA)、胆固醇(CHE)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);应用五分类全自动血液细胞分析仪XFA9500测定血血红蛋白(Hb)含量。应用SPSS 13.0统计软件进行分析。      结果      对照组认知障碍发生率为7.5%;CKD3~CKD5期患者认知障碍总体发生率为33.1%。与对照组相比,CKD3期患者认知障碍发生率明显增高,MMSE评分出现显著下降(P<0.05);CKD4期患者认知障碍发生率显著增高(P<0.01),MMSE评分降低更显著(P<0.01),CKD5期患者认知障碍发生率进一步增高(P<0.01),MMSE评分进一步降低(P<0.01)。CKD患者MMSE评分与年龄、UN、Cr、UA呈显著负相关(P<0.01),而与Hb及EGFR呈显著正相关(分别P<0.05,P<0.01)。      结论      CKD显著影响患者认知功能,认知障碍的发生及程度与患者血UN、Cr、UA、年龄、Hb浓度及eGFR值密切相关。

Abstract:

Objective      To investigate the impact of chronic kidney disease (CKD) on patients’ cognitive function and its related factors.       Methods      A total of 266 patients diagnosed with 3-5 stage CKD, age >18 years, enrolled as outpatients or inpatients in our nephrology department from June 2014 to June 2015, were subjected this study. According to the value of estimated glomerular filtration rate (eGFR), the patients were divided into stage 3 CKD group (CKD3) (60 mL/min>eGFR≥ 30 mL/min, n=92), stage 4 CKD group (CKD4) (30 mL/min>eGFR≥ 15 mL/min, n=96) and stage 5 CKD group (CKD5) (eGFR <15 mL/min, n=78). Eighty cases of control were recruited from hospital staffs following the criteria: normal appearance, eGFR>90 mL/min and matched age, sex, and education level with the patients. Mini-mental state examination (MMSE) was performed to evaluate the subjects’ cognitive function. The levels of serum creatinine (Cr), urea nitrogen (UN), uric acid (UA), cholesterol (CHE), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were determined by OLYMPUS AU2700 automatic biochemical analyzer. Hemoglobin (Hb) level was examined by XFA9500 automatic blood cell analyzer. All data were analyzed using statistical software SSPS 13.0.       Results      The overall incidence of cognitive impairment in stage 3-5 CKD groups was remarkably higher (33.1%) than that of the control (7.5%). Moreover, the incidence of cognitive impairment was increased along the CKD stage from 3 to 5. In the CKD-4 and -5 groups the increased incidence was statistically significant (P<0.01). In addition, the MMSE score was significantly decreased from stage 3 to 5 compared to the control (CKD 3 group, P<0.05; CKD-4 and -5 groups, P<0.01). The MMSE score was negatively correlated with the factors of age, UN, Cr and UA (P<0.01), but positively correlated with Hb (P<0.05) and eGFR (P<0.01).       Conclusion      CKD affects the patients’ cognitive function significantly. The incidence and severity of cognitive impairment are related closely with the levels of blood UN, Cr, UA, patients’ age, Hb concentration and eGFR.

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更新日期/Last Update: 2016-07-22