维持性血液透析患者精神心理状况分析及其与血清色氨酸水平的相关性研究

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1、纟倒寺患兄分析sm血瞅朕曲开究2018-03-2110:12:00中国现代医生2018年2期徐道祥史惠敏林小东［摘耍］n的研究維持性血液透析患者精神心理状况及其与血清色氨酸水平的相关性。方法选取我院2015年3月〜2016年12月122例进行维持性血液透析的患者及笛5例健康志愿者为研究对象，将122例进行维持性血液透析的患者纳入研究组，们5例健康志愿者纳入对照组。检测两组焦虑和抑郁等心理状况及血清色氨酸水平。结果(1)研究组患者焦虑阳性发生率和抑郁阳性发生率均高于对照组(PvO.05)。(2)抑郁组患者IL・6、犬尿氨酸

2、高于非抑郁组患者，抑郁组患者Trp、HGB低于非抑郁组患者(P<0.05)o(3)焦虑组患者Scr、BUN高于非焦虑组患者，焦虑组患者血钙、血磷低于非焦虑组患者(PvO.05)。(4)抑郁与IL・6、犬尿氨酸呈显著正相关性(r=0.351,P=0.021；r=0.256,P=0.002),焦虑与Scr、BUN呈显著正相关性(r=0.152,P=0.034；r=0.689,P=0.016)o结论炎性因子诱导使维持性血液透析患者色氨酸代谢成犬尿氨酸，中枢内5-HT水平降低，促使患者出现抑郁和焦虑等负面心理情绪，且抑郁与IL・

3、6、犬尿氨酸水平呈显著正相关性，焦虑与Scr、BUN水平呈显著正相关性。［关键词］维持性血液透析；心理状况;血清色氨酸水平；相关性［中图分类号］R692.5；R749.4［文献标识码］A［文章编1673-9701(2018)02-0001-03［Abstract］ObjectiveTostudyandanalyzethepsychologicalandmentalstateofpatientswithmaintenancehemodialysisanditscorrelationwithserumtryptophanle

4、vels.MethodsAtotalof122patientsundergoingmaintenancehemodialysisfromMarch2015toDecember2016inourhospitaland115healthyvolunteerswereselectedasthestudysubjects.122patientswithmaintenancehemodialysiswereincludedinthestudygroup,and115healthyvolunteerswereineludedinth

5、econtrolgroup.Thepsychologicalstatusofanxietyanddepressionandserumtryptophanlevelsintwogroupsweredetected.Results(1)Theincidenceofanxiety-positiveanddepression-positiveinthestudygroupwashigherthanthatinthecontrolgroup(P<0.05).(2)ThelevelsofIL-6andkynurenineinthed

6、epressiongroupwerehigherthanthoseinthenon-depressiongroup,whileTrpandHGBinthedepressiongroupwerelowerthanthoseinnon-depressiongroup(P<0.05).(3)ThelevelsofScrandBUNintheanxietygroupwerehigherthanthoseinnon-anxietygroup.Thelevelsofserumcalciumandphosphorusintheanxi

7、etygroupwerelowerthanthoseinthenon・anxietygroup(P<0.05).(4)TherewasasignificantpositivecorrelationbetweendepressionandIL-6andkynurenine(r=0.351,P=0.021；r=0.256,P=0.002),andtherewasasignificantpositivecorrelationbetweenanxietyandScrandBUN(r=0.152,P=0.034：「=0.689,P

8、=0.016).ConclusionInflammatoryfactorsinducetryptophanmetabolismintokynurenineinthepatientsundergoingmaintenaneehemodialysis.Central5-HTlevelisdecreased,inducin