维持性腹膜透析患者认知功能障碍与营养状况的关系研究

摘要 目的：探究维持性腹膜透析患者认知功能障碍与营养状况的关系。方法：前瞻性纳入2019年1月至2020年6月在济宁医学院附属医院就诊的172例维持性腹膜透析患者,收集患者一般资料。采用蒙特利尔认知评估量表（MoCA）评估患者的认知功能,根据MoCA评分分为认知功能正常组及认知功能障碍组。采用微型营养评估量表（MNA）评估患者营养状态,以MNA评分分为营养正常组、潜在营养不良组、营养不良组,比较认知功能正常组及认知功能障碍组营养状况占比情况,分析维持性腹膜透析患者认知功能与营养状况的相关性及影响认知功能的相关因素。结果：与认知功能正常组比较,认知功能障碍组患者透析时间明显延长,MNA总分、MoCA总分明显降低（P<0.05）。与认知功能正常组比较,认知功能障碍组患者营养正常者比例明显降低,营养不良者比例明显升高（P<0.05）,潜在营养不良者比例有所升高但差异无统计学意义（P>0.05）。经Pearson相关性检验分析显示,维持性腹膜透析患者MoCA总分与MNA总分呈明显正相关（P<0.05）。经Logistic回归分析显示,透析时间（延长）、营养不良均为维持性腹膜透析患者认知功能障碍的危险因素（P<0.05）。结论：维持性腹膜透析认知功能障碍患者营养不良发生率明显升高,且患者认知功能障碍与营养状况具有明显相关性,加强患者的营养状况有助于降低认知功能障碍的发生风险。

Study on the Relationship between Cognitive Impairment and Nutritional Status in Maintenance Peritoneal Dialysis Patients

ABSTRACT Objective: To explore the relationship between cognitive impairment and nutritional status in maintenance peritoneal dialysis patients. Methods: 172 maintenance peritoneal dialysis patients who were treated in the Affiliated Hospital of Jining Medical University from January 2019 to June 2020 were prospectively included, and the general data of patients were collected. The Montelier Cognitive Assessment Scale (MoCA) was used to assess the cognitive function of the patients. According to MOCA score, they were divided into normal cognitive function group and cognitive impairment group. The nutritional status of patients was assessed by mini nutritional assessment (MNA). According to MNA score, they were was divided into normal nutrition group, potential malnutrition group and malnutrition group. The proportion of nutritional status in normal cognitive function group and cognitive impairment group was compared, and the correlation between cognitive function and nutritional status and related factors affecting cognitive function in maintenance peritoneal dialysis patients were analyzed. Results: Compared with the normal cognitive function group, the dialysis time in the cognitive impairment group was significantly longer, and the total scores of MNA and MOCA were significantly lower(P<0.05). Compared with the normal cognitive function group, the proportion of patients with normal nutrition decreased significantly, the proportion of malnutrition increased significantly (P<0.05), and the proportion of potential malnutrition increased, but the difference was not statistically significant (P>0.05). Pearson correlation test showed that there was a significant positive correlation between the total score of MOCA and the total score of MNA in maintenance peritoneal dialysis patients (P<0.05). Logistic regression analysis showed that dialysis time (prolonged) and malnutrition were the risk factors of cognitive impairment in maintenance peritoneal dialysis patients (P<0.05). Conclusion: The incidence of malnutrition in cognitive impairment in maintenance peritoneal dialysis patients is significantly increased, and there is a significant correlation between cognitive impairment and nutritional status. Strengthening the nutritional status of patients will help to reduce the risk of cognitive impairment.