血液透析老年患者中疼痛-抑郁共病与日常生活能力的相关性研究^*

Impact of comorbidity of pain and depression on activities of daily living in elderly patients on hemodialysis

摘要

目的 探究维持性血液透析老年患者疼痛-抑郁共病的现况, 分析与日常生活能力 (ADL) 的相关性。方法 选取 2023 年 4 月—10 月北京友谊医院进行维持性血液透析治疗的老年患者作为研究对象。 评估患者疼痛程度、 抑郁情绪及 ADL。 采用多因素 logistic 回归模型探究疼痛-抑郁共病与维持性血液透析老年患者 ADL 的相关性及 ADL 下降的影响因素。结果 共纳入 208 例患者, 45 例 (21.6%) 具有疼痛-抑郁共病, 42 例 (20.2%) 合并 ADL 下降。 与无疼痛抑郁组相比较, 疼痛-抑郁共病组患者合并 ADL 下降的更多 (P<0.05)。 多因素 logistic 回归分析显示, 疼痛-抑郁共病、 年龄、 握力及透析前血肌酐是维持性血液透析老年患者 ADL 下降的独立影响因素 (P<0.05)。结论 维持性血液透析老年患者中疼痛-抑郁共病的患病率较高, 疼痛-抑郁共病、 年龄、 握力及透析前血肌酐是维持性血液透析老年患者 ADL 下降的独立影响因素。

Abstract

Objective To investigate the status of pain-depression comorbidity in elderly maintenance hemodialysis patients and analyze its correlation with activities of daily living (ADL). Methods Elderly patients who underwent maintenance hemodialysis in Beijing Friendship Hospital from April to October 2023 were selected as the study subjects. Patients were assessed for pain, depression, and ADL. Multivariate logistic regression model was used to investigate the correlation between pain-depression comorbidity and ADL and the influencing factors of ADL decline in elderly maintenance hemodialysis patients. Results A total of 208 patients were included, 45 (21.6%) had pain-depression comorbidity and 42 (20.2%) had decreased ADL. Patients in the pain-depression comorbidity group had more decreased ADL compared with the pain-free depression group (P<0.05). Multivariate logistic regression analysis showed that pain-depression comorbidity, age, grip strength and predialysis serum creatinine were independent factors for ADL decline in elderly maintenance hemodialysis patients (P<0.05). Conclusion The prevalence of pain-depression comorbidity was higher in elderly maintenance hemodialysis patients, and pain-depression comorbidity, age, grip strength, and predialysis serum creatinine were independent factors for ADL decline in elderly maintenance hemodialysis patients.

关键词

慢性疼痛 / 抑郁 / 日常生活活动能力 / 血液透析

Key words

Chronic pain / Depression / Activities of daily living / Hemodialysis

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基金资助

^*首都卫生发展科研专项(2022-2-2028)