比较高通量血液透析和常规血液透析对认知障碍的长期影响

发布时间：2018-03-26 10:40

本文选题：认知障碍　切入点：高通量血液透析　出处：《河北医科大学》2015年硕士论文

【摘要】：目的:越来越多的研究表明血液透析患者中普遍存在认知障碍,同时发现与常规血液透析相比,高通量血液透析对患者的认知功能具有保护作用。然而,目前的研究主要集中于血液透析对认知功能的短期影响。在本实验中,我们研究的是比较高通量血液透析和常规血液透析对患者的认知障碍的长期影响。此外,我们研究了β2-微球蛋白对认知功能的影响。方法:招募河北医科大学第二医院中接受血液透析的122位慢性肾脏疾病患者为实验对象。62位患者接受持续12个月的常规血液透析,其余60位患者接受12个月的高通量血液透析。血液透析结束24小时后,患者返回医院做全面健康检查,确保患者能够完成认知功能测试。122位患者完成认知功能测试(15min)后,留取患者血液样本检测β2-微球蛋白的水平。采用中文版蒙特利尔认知量表(Montreal Cognitive Assessment,Mo CA)进行认知功能评估,windows系统下的Microsoft Excel 2010和IBM SPSS统计20软件进行数据统计分析。并分析与认知功能损害相关的危险因素。结果:1人口数据显示在常规血液透析组和高通量血液透析组中患者的一般身体条件无显著差异。2 24小时内(短期内),经Mo CA评估后发现高通量血液透析组的患者表现出较低水平的认知障碍。3长期来看,高通量透析和常规透析对认知障碍的影响方面没有显著性差异,甚至在认知功能的某些指标中的恶化率较高。4β2-微球蛋白升高以及累积速率可能与认知功能的下降有关。结论:在短期观察内,高通量血液透析组的患者显示出更好的执行能力、视觉空间能力和短期记忆;在长期观察内,两组患者显示出相同水平的认知障碍。此外,在12个月内,与常规血液透析患者相比,高通量血液透析患者在执行能力、视觉空间能力和语言表达能力等方面存在较高的恶化率,这可能和β2-微球蛋白的累积速率有关。
[Abstract]:Objective: a growing number of studies have shown that cognitive impairment is prevalent in hemodialysis patients and that high-throughput hemodialysis has protective effects on cognitive function compared with conventional hemodialysis. The current study focuses on the short-term effects of hemodialysis on cognitive function. In this study, we studied the long-term effects of high-throughput hemodialysis and conventional hemodialysis on cognitive impairment in patients. We studied the effect of 尾 _ 2-microglobulin on cognitive function. Methods: 122 patients with chronic renal disease who received hemodialysis in the second Hospital of Hebei Medical University were selected as subjects. 62 patients received routine hemodialysis for 12 months. The remaining 60 patients received 12 months of high-throughput hemodialysis. After 24 hours of hemodialysis, the patients returned to the hospital for a comprehensive health examination to ensure that the patients were able to complete the cognitive function test .122 patients completed the cognitive function test for 15 minutes. The level of 尾 _ 2-microglobulin was detected in patients' blood samples. Microsoft Excel 2010 and IBM SPSS statistical 20 software were used to evaluate the cognitive function of patients with Microsoft Excel 2010 and IBM SPSS statistical 20 software under windows system. Analysis of risk factors associated with cognitive impairment. Results the population data at 1: 1 showed no significant difference in general physical conditions between the conventional hemodialysis group and the high flux hemodialysis group within 2. 2 hours (short-term, via Mo). CA evaluation found that patients in the high-throughput hemodialysis group showed lower levels of cognitive impairment in the long run. There was no significant difference in the effects of high-throughput dialysis and routine dialysis on cognitive impairment. Even in some indicators of cognitive function, the deterioration rate was higher. 4 尾 2-microglobulin increased and the accumulation rate may be related to the decline of cognitive function. Conclusion: in the short term, the patients in the high flux hemodialysis group showed better executive ability. Visual spatial ability and short-term memory; in long-term observation, the two groups showed the same level of cognitive impairment. In addition, within 12 months, high-throughput hemodialysis patients had executive ability compared with those with conventional hemodialysis. There is a high deterioration rate in visual spatial ability and language expression ability, which may be related to the accumulation rate of 尾 _ 2-microglobulin.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R459.5

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