高通量血液透析联合草酸艾司西酞普兰对尿毒症伴焦虑抑郁患者临床应用研究

目的:探讨高通量血液透析联合草酸艾司西酞普兰对尿毒症伴焦虑抑郁患者血清钙磷代谢、营养状态和不良心理状态的影响。方法:选取2016年2月～2018年8月期间保定市第一中心医院收治的尿毒症伴焦虑抑郁患者113例,根据数字表法将患者随机分为对照组(n=56)和研究组(n=57),对照组给予心理治疗和常规血液透析治疗,研究组给予高通量血液透析联合草酸艾司西酞普兰治疗。比较两组患者钙、磷水平、营养状态、焦虑抑郁评分,记录两组不良反应发生情况。结果:两组患者治疗3个月后磷下降,且研究组低于对照组(P0.05),研究组磷水平达标率均高于对照组(P0.05)。研究组治疗3个月后白蛋白(Alb)、血红蛋白(Hb)、总蛋白(TP)、转铁蛋白(TRF)较治疗前升高,且研究组高于对照组同时间点(P0.05)。两组治疗3个月后汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分较治疗前下降,且研究组低于对照组(P0.05)。两组患者不良反应发生率比较无差异(P0.05)。结论:高通量血液透析联合草酸艾司西酞普兰治疗尿毒症伴焦虑抑郁患者,可有效降低血清磷水平,改善机体营养状态,缓解焦虑抑郁情绪,同时不增加不良反应发生率,临床应用价值较高。

Clinical Application of High Flux Hemodialysis Combined with Escitalopram Oxalate in Uremia Patients with Anxiety and Depression

ABSTRACT Objective: To investigate the effects of high flux hemodialysis combined with escitalopram oxalate on serum calcium and phosphorus metabolism, nutritional status and adverse psychological status in uremic patients with anxiety and depression. Methods: 113 uremic patients with anxiety and depression who were admitted to Baoding First Central Hospital from February 2016 to August 2018 were selected, they were randomly divided into control group (n=56) and study group (n=57) according to the digital table method. The control group was treated with psychotherapy and routine hemodialysis, and the study group was treated with high flux hemodialysis combined with escitalopram oxalate. Calcium and phosphorus levels, nutritional status, anxiety and depression scores were compared between the two groups, and the occurrence of adverse reactions in the two groups was recorded. Results: Phosphorus in the two groups decreased at 3 months after treatment, and that in the study group was lower than that in the control group (P<0.05). The rate of reaching the standard of phosphorus in the study group was higher than those in the control group (P<0.05). The albumin (Alb), hemoglobin (Hb), total protein (TP), transferrin (TRF) in the study group at 3 months after treatment were higher than those before treatment, and those in the study group were higher than those in the control group at the same time point (P<0.05). The scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the study group at 3 months after treatment were lower than those before treatment, and those in the study group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: High flux hemodialysis combined with escitalopram oxalate in the treatment of uremia patients with anxiety and depression can effectively reduce the level of serum phosphorus, improve the nutritional status of the body, alleviate anxiety and depression, while not increasing the incidence of adverse reactions, and it has high clinical value.