维持性血液透析患者认知功能的调查分析

摘要

Objective To explore the changes of cognitive function in patients with chronic renal failure and receiving maintenance hemodialysis therapy.Methods A convenience sample of 69 MHD patients and 40 healthy people with normal kidney function matched for demographic information, vascular disease and other comorbidity were included. A battery of eight validated neuropsychological tests was administered to estimate their cognitive function, including: MoCA, Auditory Verbal Memory Test(AVMT), Symbol digit modalities test(SDMT), Digit span test (DST), Rey-Osterrieth Complex Figure Test(CFT) ,Trail Making Test (TMT), Stroop Color Words Test(SCWT), Verbal Fluency Test(VFT). Results Compare to controls, the percentage of subjects with impairment was significantly higher in MHD subjects. In each tested cognitive domain, including memory and non-memory domain, MHD subjects had signiifcantly lower scores.Conclusion MHD patients had various cognitive impairment and performed signiifcantly worse on the domain of memory, attention and processing, executive function, language. Early initiation of proper treatment may help lower the incidence of cognitive impairment.%目的：探讨慢性肾衰竭（CRF）维持性血液透析（MHD）患者的认知功能变化，为临床护理工作提供理论依据。方法采用中文版蒙特利尔认知评估量表、听觉词语回忆测验、连线测验、Stroop色词测验、数字广度测验、符号数字转换测验以及言语流畅性测验对69例MHD患者及40例健康对照组进行认知评定。结果 MHD组认知功能障碍的发生率高于对照组（P＜0.05）。在记忆测验方面，MHD组患者听觉词语回忆测验及复杂图片测验得分均低于对照组（P＜0.05）；非记忆测验方面，MHD组言语流畅性测验得分低于对照组（P＜0.05），连线测验-A和连线测验-B耗时数比对照组延长（P＜0.05）；Stroop色词测验B、C及复杂图片测验得分均低于对照组（P＜0.05）。结论MHD患者存在多方面的认知功能损害，主要表现在记忆力减退、注意力和知觉运动速度下降、执行功能和语言能力降低，应及早采取护理干预措施。