慢性肾病对患者认知功能的影响及其相关因素的初步研究

吴静; 邓志宽; 赵景宏; 黄云剑; 冯兵

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慢性肾病对患者认知功能的影响及其相关因素的初步研究

临床医学 | 更新时间：2026-01-09

- 慢性肾病对患者认知功能的影响及其相关因素的初步研究
- Impact of chronic kidney disease on patients’ cognitive function and its related factors: a preliminary study
- 陆军军医大学学报 2016年38卷第15期页码：1773-1776
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  中图分类号： R181.32;R692.06;R741
- 纸质出版：2016
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吴静,邓志宽,赵景宏,黄云剑,冯兵.慢性肾病对患者认知功能的影响及其相关因素的初步研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(15):1773-1776.

　Wu Jing,Deng Zhikuan,Zhao Jinghong,Huang Yunjian,Feng Bing.Impact of chronic kidney disease on patients’ cognitive function and its related factors: a preliminary study[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(15):1773-1776.
吴静,邓志宽,赵景宏,黄云剑,冯兵.慢性肾病对患者认知功能的影响及其相关因素的初步研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(15):1773-1776. DOI：

　Wu Jing,Deng Zhikuan,Zhao Jinghong,Huang Yunjian,Feng Bing.Impact of chronic kidney disease on patients’ cognitive function and its related factors: a preliminary study[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(15):1773-1776. DOI：

摘要

目的探讨慢性肾病（chronic kidney disease

CKD）对患者认知功能的影响及其相关因素。方法选择2014年6月至2015年6月在本院肾内科门诊就诊或住院，年龄＞18岁，诊断为慢性肾病3～5期的患者266例，根据估计肾小球滤过率（estimated glomerular filtration rate，eGFR）水平分别纳入3期CKD（CKD3）组（60 mL/min＞eGFR≥30 mL/min，92例）、4期CKD(CKD4)组（30 mL/min＞eGFR≥15 mL/min，96例）和5期CKD(CKD5)组（EGFR＜15 mL/min，78例）。选择年龄、性别及教育程度相匹配的、eGFR＞90 mL/min、外观基本正常的人群80例作为对照组。应用简易智力状况检查法(mini-mental state examination

MMSE)检测患者智能状态；应用OLYMPUS AU2700 全自动生化分析仪测定血清肌酐（Cr）、尿素氮(UN)、尿酸(UA)、胆固醇(CHE)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)；应用五分类全自动血液细胞分析仪XFA9500测定血血红蛋白（Hb）含量。应用SPSS 13.0统计软件进行分析。结果对照组认知障碍发生率为7.5%；CKD3～CKD5期患者认知障碍总体发生率为33.1%。与对照组相比，CKD3期患者认知障碍发生率明显增高，MMSE评分出现显著下降（P0.05）；CKD4期患者认知障碍发生率显著增高（P0.01），MMSE评分降低更显著（P0.01），CKD5期患者认知障碍发生率进一步增高（P0.01），MMSE评分进一步降低（P0.01）。CKD患者MMSE评分与年龄、UN、Cr、UA呈显著负相关（P0.01），而与Hb及EGFR呈显著正相关（分别P0.05，P0.01）。结论 CKD显著影响患者认知功能，认知障碍的发生及程度与患者血UN、Cr、UA、年龄、Hb浓度及eGFR值密切相关。

Abstract

Objective To investigate the impact of chronic kidney disease (CKD) on patients’ cognitive function and its related factors. Methods A total of 266 patients diagnosed with 3-5 stage CKD

age 18 years

enrolled as outpatients or inpatients in our nephrology department from June 2014 to June 2015

were subjected this study. According to the value of estimated glomerular filtration rate (eGFR)

the patients were divided into stage 3 CKD group (CKD3) (60 mL/min＞eGFR≥ 30 mL/min

n=92)

stage 4 CKD group (CKD4) (30 mL/min＞eGFR≥ 15 mL/min

n=96) and stage 5 CKD group (CKD5) (eGFR 15 mL/min

n=78). Eighty cases of control were recruited from hospital staffs following the criteria: normal appearance

eGFR90 mL/min and matched age

sex

and education level with the patients. Mini-mental state examination (MMSE) was performed to evaluate the subjects’ cognitive function. The levels of serum creatinine (Cr)

urea nitrogen (UN)

uric acid (UA)

cholesterol (CHE)

high density lipoprotein cholesterol (HDL-C)

and low density lipoprotein cholesterol (LDL-C) were determined by OLYMPUS AU2700 automatic biochemical analyzer. Hemoglobin (Hb) level was examined by XFA9500 automatic blood cell analyzer. All data were analyzed using statistical software SSPS 13.0. Results The overall incidence of cognitive impairment in stage 3-5 CKD groups was remarkably higher (33.1%) than that of the control (7.5%). Moreover

the incidence of cognitive impairment was increased along the CKD stage from 3 to 5. In the CKD-4 and -5 groups the increased incidence was statistically significant (P0.01). In addition

the MMSE score was significantly decreased from stage 3 to 5 compared to the control (CKD 3 group

P0.05; CKD-4 and -5 groups

P0.01). The MMSE score was negatively correlated with the factors of age

Cr and UA (P0.01)

but positively correlated with Hb (P0.05) and eGFR (P0.01). Conclusion CKD affects the patients’ cognitive function significantly. The incidence and severity of cognitive impairment are related closely with the levels of blood UN

patients’ age

Hb concentration and eGFR.

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