慢性肾脏病患者焦虑抑郁状况的调查

An investigation into anxiety and depression in patients with chronic kidney disease

摘要:

目的 观察慢性肾脏病(CKD)患者的焦虑抑郁状况。方法 入选2018年6月至2019年4月期间在江苏省人民医院老年医学科住院治疗的CKD患者225例为研究对象。采用慢性肾脏病流行病学合作研究公式计算估算的肾小球滤过率。采用汉密尔顿焦虑量表(HARS)和汉密尔顿抑郁量表(HDRS)对患者进行评估。采用SPSS 23.0软件进行数据处理。多因素logistic回归分析筛选出独立危险因素。Pearson相关分析研究观察指标间的相关性。结果 依据HARS评分结果分为3组:无焦虑组(n＝95),轻度焦虑组(n＝110)和中重度焦虑组(n＝20)。依据HDRS评分结果分为3组:无抑郁组(n＝72),轻度抑郁组(n＝119)和中重度抑郁组(n＝34)。低的估算的肾小球滤过率(焦虑:OR=1.35,95%CI 1.04~1.76；抑郁:OR=1.93,95%CI 1.40~2.66)和增龄(焦虑:OR=1.04,95%CI 1.02~1.76；抑郁:OR=1.03,95%CI 1.00~1.05)是CKD患者合并焦虑及抑郁症状的危险因素(P＜0.05)。焦虑评分和抑郁评分呈显著正相关(r=0.694,P<0.001)。结论 肾功能下降和增龄是CKD患者出现焦虑抑郁症状的独立危险因素。随着肾功能下降及年龄增加,不同程度焦虑抑郁的发生率均显著增加。

Abstract:

Objective To observe anxiety and depression of the patients with chronic kidney disease (CKD). Methods Included in the study were a total of 225 patients with CKD, who were hospitalized in the Geriatric Department of the People′s Hospital of Jiangsu Province from June 2018 to April 2019. Chronic kidney disease epidemiology collaboration formula was used to calculate the estimated glomerular filtration rate (eGFR), and Hamilton anxiety rating scale (HARS) and Hamilton depression rating scale (HDRS) were used to evaluate the patients. Data were processed using SPSS statistics 23.0. Multivariate logistic regression analysis were performed to screen for independent risk factors. Pearson correlation analysis was conducted to study the correlation between indicators. Results According to HARS score, the patients were divided into non-anxiety (NA; n=95), mild-anxiety (MA; n=110), and moderate-to-severe anxiety (MSA; n=20) groups; and according to the HDRS score, into non-depression (ND; n=72), mild-depression (MD; n=119) and moderate-to-severe depression (MSD; n=34) groups. The risk factors for anxiety and depression in the CKD patients included lower eGFR (anxiety:OR=1.35,5%CI 1.04-1.76; depression:OR=1.93,5%CI 1.40-2.66) and aging (anxiety:OR=1.04,5%CI 1.02-1.76; depression:OR=1.03, 95%CI 1.00-1.05) (P<0.05). A marked positive correlation was observed between anxiety score and depression score (r=0.694,P<0.001). Conclusion Decreased renal function and aging are independent risk factors for anxiety and depression in CKD patients. With the decline of renal function and aging, the incidence of anxiety and depression at various levels increases obviously.