ABSTRACT
Objective To evaluate the influence of different blood purification ways on the incidence,distribution characteristics and related factors of depressive symptoms in end-stage renal disease (ESRD) patients.Methods Self-made questionnaires,short form 36 health survey questionnaire(SF-36),self-rating depression scale (SRS),medical coping modes questionnaire (MCMQ) and social support rating scale(SSRS) were performed to assess 80 hemodialysis patients and 78 continuous ambulatory peritoneal dialysis patients.If SDS score was higher than 53,the patient was diagnosed according to ICD-10.Results ①The detection rate of depressive symptoms in patients with ESRD was 61.22％,in which 50.8％ case met the diagnostic criteria of ICD-10.②Peritoneal dialysis group were better than hemodialysis group on the SF-36 (61.60± 18.50 vs 52.70 ± 20.00),comprehensive nutritional assessment (58.21 ± 13.56 vs 25.40 ± 11.21),urea clearance index(52.43± 14.20 vs 21.02±0.62) and SDS score (24.25±0.45 vs 23.89±0.91),and the results were statistically significant (P＜0.05).③Correlation analysis showed that the depression of ESRD patients was significantly negatively correlated with gender,educational level and household income (r =-0.278,-0.275,-0.283,P＜0.05),but positively correlated with course of disease(r=0.298,P＜0.05).In addition,the depressive symptoms were significantly negatively correlated with the face and avoidance factor of coping styles(r=-0.343,-0.316,P＜0.05),but positively correlated with yield(r=0.338,P＜0.05).Moreover,they were negatively correlated with objective support,subjective support and support utilization score (r=-0.330,-0.325,-0.297,P＜ 0.05).④Regression analysis showed that education level,social support and medical coping styles were influencing factors for patients with depression.The choice of dialysis way was also the influencing factor of depression occurrence.Conclusion Nutrition and urea nitrogen removal in peritoneal dialysis group is better than that in hemodialysis group.Education degree,social support,medical coping styles and dialysis way are the influencing factors of depression in ESRD patients.
ABSTRACT
Objective To invest the effect of minimal inflammation on patients with maintenance hemodialysis(MHD) and the intervention effect of ftuvastatin.Methods Blood indicators such as PA,ALB and BUN,Cr,TC,TG,HDL-C,LDL-C,Lp(a),SF,hs-CRP,IL-6 and TNF-α were detected at the first day of the study and six months later in all patients.Patients were divided into inflammation group(CRP≥8 mg/L) and non-inflammation group(CRP<8 mg/L) according to CRP levels.Only inflammation group used fluvastatin.Two groups were observed for six months.Results The level of hs-CRP,IL-6,TNF-α,TG,Lp(a),SF in MHD patients was obviously higher than the normal control group.The level of ALB was obviously lower than the normal control group.The angiocardiopathy incidence of inflammation group was obviously higher than that of the non-inflammation.The more obvious of minimal inflammation,the more significant of lipid metabolism disturbance and malnutrition.Hs-CRP,IL-6,TG,TC,LDL-C and Lp(a) of inflammation group decreased obviously(P<0.01 or P<0.05).ALB、HDL-C increased obviously(P<0.05).Indicators of the non-inflammation had no statistical difference after therapy.Conclusions Patients with MHD generally have minimal inflammation and malnutrition.Minimal inflammation has important effect on the angiocardiopathyincidence,lipid metabolism disturbance and malnutrition.Fluvastatin not only could regulate lipid metabolism but also improve the minimal inflammation of patients with MHD.Early detection and therapy of minimal inflammation has important significance on improving prognosis of patients with MHD.