本文選題：認(rèn)知障礙　切入點：高通量血液透析　出處：《河北醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:越來越多的研究表明血液透析患者中普遍存在認(rèn)知障礙,同時發(fā)現(xiàn)與常規(guī)血液透析相比,高通量血液透析對患者的認(rèn)知功能具有保護(hù)作用。然而,目前的研究主要集中于血液透析對認(rèn)知功能的短期影響。在本實驗中,我們研究的是比較高通量血液透析和常規(guī)血液透析對患者的認(rèn)知障礙的長期影響。此外,我們研究了β2-微球蛋白對認(rèn)知功能的影響。方法:招募河北醫(yī)科大學(xué)第二醫(yī)院中接受血液透析的122位慢性腎臟疾病患者為實驗對象。62位患者接受持續(xù)12個月的常規(guī)血液透析,其余60位患者接受12個月的高通量血液透析。血液透析結(jié)束24小時后,患者返回醫(yī)院做全面健康檢查,確�；颊吣軌蛲瓿烧J(rèn)知功能測試。122位患者完成認(rèn)知功能測試(15min)后,留取患者血液樣本檢測β2-微球蛋白的水平。采用中文版蒙特利爾認(rèn)知量表(Montreal Cognitive Assessment,Mo CA)進(jìn)行認(rèn)知功能評估,windows系統(tǒng)下的Microsoft Excel 2010和IBM SPSS統(tǒng)計20軟件進(jìn)行數(shù)據(jù)統(tǒng)計分析。并分析與認(rèn)知功能損害相關(guān)的危險因素。結(jié)果:1人口數(shù)據(jù)顯示在常規(guī)血液透析組和高通量血液透析組中患者的一般身體條件無顯著差異。2 24小時內(nèi)(短期內(nèi)),經(jīng)Mo CA評估后發(fā)現(xiàn)高通量血液透析組的患者表現(xiàn)出較低水平的認(rèn)知障礙。3長期來看,高通量透析和常規(guī)透析對認(rèn)知障礙的影響方面沒有顯著性差異,甚至在認(rèn)知功能的某些指標(biāo)中的惡化率較高。4β2-微球蛋白升高以及累積速率可能與認(rèn)知功能的下降有關(guān)。結(jié)論:在短期觀察內(nèi),高通量血液透析組的患者顯示出更好的執(zhí)行能力、視覺空間能力和短期記憶;在長期觀察內(nèi),兩組患者顯示出相同水平的認(rèn)知障礙。此外,在12個月內(nèi),與常規(guī)血液透析患者相比,高通量血液透析患者在執(zhí)行能力、視覺空間能力和語言表達(dá)能力等方面存在較高的惡化率,這可能和β2-微球蛋白的累積速率有關(guān)。
[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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R459.5

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