RESUMO
Objective To explore the effects of cognitive impairment on the self-management ability and self-management behavior among the patients of end stage renal disease (ESRD) with maintenance hemodialysis (MHD).Methods 134 MHD patients were divided into the non cognitive impairment group(62 subjects) and cognitive impairment group(72 subjects) according to Montreal cognitive assessment (MoCA)scores,to asses and analyze the level of hemodialysis knowledge,hemodialysis adherence,self-management ability and self-management behavior between the two groups.Results The rates of hemodialysis skipping behavior and the rates of hemodialysis shorting behavior in cognitive impairment group (respectively,18.06％,22.22％) were higher than that in non cognitive impairment group(respectively,6.45％,8.06％) with significant difference (x2 =4.0495,5.0526,all P＜0.05).The cognitive impairment group had significantly less total score (respectively,16.62 ± 1.99,51.32± 9.92,56.99±8.3) in the level of hemodialysis knowledge,the self-management ability and the self-management behavior compared with the non cognitive impairment group(respectively,18.48±2.03,63.69±10.16,78.54± 10.28) (t=5.3448,7.1172,13.4140,all P＜0.05).Conclusion Cognitive impairment can produce an effect on the level of hemodialysis knowledge and hemodialysis adherence.Cognitive impairment can also reduce the function of self-management ability and self-management behavior and make badly further effect on curative effect of hemodialysis.
RESUMO
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.