Dahbour Said S, Wahbeh Ayman M, Hamdan Mohammad Z
Medical Department, Jordan University, Amman, Jordan.
Hemodial Int. 2009 Jan;13(1):80-5. doi: 10.1111/j.1542-4758.2009.00343.x.
Cognitive impairment is common in hemodialysis (HD) patients. The mini mental status examination is a simple screening test for dementia. The objectives of this study were to (1) study and compare the predialysis and postdialysis mini mental status examination score and 2 subscores and compare them with those of a control group and (2) determine the factors affecting these scores. This was a prospective study of 54 HD patients, which involved calculation of their predialysis (PrHDSc) and (2-4 weeks later) postdialysis (PoHDSc) scores and comparison of these with the control scores (CoSc). The mean scores for PreHDSc and PoHDSc were 26.5+/-2.7 and 26.4+/-3.3, respectively. Both were significantly lower than CoSc, 28.4+/-1.6 (95% CI for score difference 0.99-2.97, P<0.001). The subscores for orientation, registration, and recall (ORR) and attention (ATT) before and after HD were 14.2+/-1.3, 14.3+/-1.8, and 3.5+/-1.7, 3.2+/-1.8, respectively. Both were significantly lower than the CoSc, 15.2+/-1.2 and 4.2+/-1.1 (P=0.001 and 0.004, respectively). There were no significant differences between the PrHDSc and PoHDSc (P values of 0.87, 0.63, and 0.45, respectively). Patients' PrHDSc correlated positively with PoHDSc and dialysis efficiency measured by the urea reduction ratio and Kt/V (r=0.58, 0.4, and 0.34, respectively). Education level correlated positively with PrHDSc r=0.41 but not PoHDSc. Hemodialysis duration correlated negatively with PrHDSc r=-0.3. There was no correlation among age, chronic renal failure duration, HD frequency, weight loss, systolic or diastolic blood pressure drop, and PrHDSc or PoHDSc. Hemodialysis patients scored significantly less than the control patients. Their score was not affected by HD. This may reflect the stable cognitive function/dysfunction or the mild sensitivity of the test.
认知障碍在血液透析（HD）患者中很常见。简易精神状态检查表是一种用于痴呆症的简单筛查测试。本研究的目的是：（1）研究并比较透析前和透析后的简易精神状态检查表得分及两个子得分，并将其与对照组的得分进行比较；（2）确定影响这些得分的因素。这是一项对54名HD患者的前瞻性研究，涉及计算他们的透析前（PrHDSc）得分和（2至4周后）透析后（PoHDSc）得分，并将这些得分与对照组得分（CoSc）进行比较。PrHDSc和PoHDSc的平均得分分别为26.5±2.7和26.4±3.3。两者均显著低于CoSc，即28.4±1.6（得分差异的95%置信区间为0.99至2.97，P<0.001）。HD前后的定向、记忆和回忆（ORR）子得分以及注意力（ATT）子得分分别为14.2±1.3、14.3±1.8和3.5±1.7、3.2±1.8。两者均显著低于CoSc，分别为15.2±1.2和4.2±1.1（P值分别为0.001和0.004）。PrHDSc和PoHDSc之间无显著差异（P值分别为0.87、0.63和0.45）。患者的PrHDSc与PoHDSc以及用尿素清除率和Kt/V衡量的透析效率呈正相关（r分别为0.58、0.4和0.34）。教育水平与PrHDSc呈正相关（r=0.41），但与PoHDSc无关。血液透析时长与PrHDSc呈负相关（r=-0.3）。年龄、慢性肾衰竭时长、HD频率、体重减轻、收缩压或舒张压下降与PrHDSc或PoHDSc之间均无相关性。血液透析患者的得分显著低于对照组患者。他们的得分不受HD影响。这可能反映了认知功能/功能障碍的稳定性或该测试的轻度敏感性。
