CAJ | 학술논문

目的：调查维持性血液透析老年患者认知功能状态并探讨其相关危险因素，为维持性血液透析患者慢病管理提供理论依据。方法应用中文版简易精神状态检查量表（ mini－mental state examination， CMMSE）和自理能力量表（ activity of daily living scale， ADL）对112例60岁以上的维持性血液透析患者进行神经心理评估和自理能力评估，记录参与者性别、年龄、文化程度、透析龄、血管通路、原发病、既往病史等基本资料，同时记录最近一次的血红蛋白、血清白蛋白水平等实验室数据。结果112例患者完成调查，平均得分为24．9±5．7，其中75例CMMSE得分小于27分，37例得分大于27分，故本组老年患者认知功能损害发生率为67．0％；按是否发生认知功能损害将患者分为损害组与正常组，比较两组间的一般资料发现，性别构成、年龄构成、受教育程度、糖尿病史、自理能力、血清白蛋白水平存在明显差异，有统计学意义（P＜0．05）；结论在维持性血液透析的老年患者中普遍存在认知功能损害；发生认知功能损害的相关危险因素有年龄构成、受教育程度、糖尿病史、自理能力、血清白蛋白水平；年龄越大、文化程度越低、自理能力越低，发生认知功能损害的可能越大。
목적：조사유지성혈액투석노년환자인지공능상태병탐토기상관위험인소，위유지성혈액투석환자만병관리제공이론의거。방법응용중문판간역정신상태검사량표（ mini－mental state examination， CMMSE）화자리능역량표（ activity of daily living scale， ADL）대112례60세이상적유지성혈액투석환자진행신경심리평고화자리능력평고，기록삼여자성별、년령、문화정도、투석령、혈관통로、원발병、기왕병사등기본자료，동시기록최근일차적혈홍단백、혈청백단백수평등실험실수거。결과112례환자완성조사，평균득분위24．9±5．7，기중75례CMMSE득분소우27분，37례득분대우27분，고본조노년환자인지공능손해발생솔위67．0％；안시부발생인지공능손해장환자분위손해조여정상조，비교량조간적일반자료발현，성별구성、년령구성、수교육정도、당뇨병사、자리능력、혈청백단백수평존재명현차이，유통계학의의（P＜0．05）；결론재유지성혈액투석적노년환자중보편존재인지공능손해；발생인지공능손해적상관위험인소유년령구성、수교육정도、당뇨병사、자리능력、혈청백단백수평；년령월대、문화정도월저、자리능력월저，발생인지공능손해적가능월대。
Objective To investigate the cognitive status of elder patients with maintenance hemodialysis ( MHD) and the risk factors of cognitive impairment in these patients in order to pro-vide clues for the management of chronic patients with MHD.Methods A total of 112 patients at age of 60 or older who received MHD were enrolled in this study.Cognitive performance was evalua-ted by Chinese Simple Mental State Examination Scale ( CMMSE) and Activity of Daily Living Scale ( ADL) .Clinical data, including gender, age, education level, dialysis duration, vascular ac-cess, primary diseases, and medical history, were recorded, and the last pre-dialysis hemoglobin and serum albumin measurements were obtained.Results The average CMMSE score was 24.9 ± 5.7.CMMSE score was less than 27 points in 75 cases and 37 cases scored more than 27 points.The cognitive impairment rate in this cohort was 67.0%.There was significant difference in sex, age, level of education, history of diabetes, self-care ability, and serum albumin level between cogni-tive impairment group and normal group ( P<0.05 ) .Conclusion Cognitive impairment is com-mon in elder MHD patients.The risk factors for cognitive impairment are age, level of education, diabetes, self-care ability and serum albumin levels.The patients with elder age, low education and self-care disability are more likely to develop cognitive impairment.