| Background and purpose:The attention to psychological disease is increasing now with the establishment of the biological-psychology-social medical model. In2002the world health organization reported, according to the current development speed, the depression is expected to become the world’s second largest source of disease burden the second only to coronary heart disease in2020.Depression, anxiety is the most common mental illness in maintenance hemodialysis (MHD) patients, the patient’s body and mind has had a huge impact, in some sense, even more than physiological and dialysis parameters. In recent years, neurotrophic hypothesis of depression disorder has been put forward as to the brain derived neurotrophic factor (BDNF) maintain the neurons survival, promote synaptic growth, all sorts of reasons cause a lack of BDNF in the brain and the brain dysfunction can lead to depression. BDNF and neurotrophin-3have wide role in central and peripheral nervous system and received wide attention in the field of neuropsychological research as the important member in the family of neurotrophic factors.The purpose of this study was to assess the mental health status of MHD patients, analysised of anxiety and depression scores and common physiological indexes and the relationship between BDNF and the NT-3, screening index of affect mood, so as to the occurrence of anxiety, depression and other mental illness development play a warning role, timely found psychological influence related indicators, provide a certain basis for the early discovery and prevent diseases. Also hope that through this study to improve the recognition of clinical doctors and patients to mental illness and attention, in the treatment of somatic symptoms at the same time give spiritual and psychological intervention, promote the physical and mental health.Methods:From October2012to June2013,114patients with data integritywho received maintenance hemodialysis treatment in the Hemodialysis center from the Affiliated Hospital of Medical College of Yanbian University inYilin were recruited. The standard set:The patients with end-stage renal failure accepted maintenance hemodialysis more than3months.no dialysis change in the way in3months; Clear consciousness, having certain communication skills, understanding and cooperating with the investigation; Obtain the consent of the patients and their families. Exclusion criteria:exclude dottiness, brain trauma, brain tumors and having a personality disorder.Normal group:Hospital staff and volunteers with health and no mental illness and similar family history previous. No statistical differences between hemodialysis group and normal control group in the age and gender.Both the two groups received general situation questionnaire and Zung depression self rating scale (SDS) Zung self rating anxiety scale (SAS), and the determination of the related test indicators, using enzyme-linked immunosorbent assay (ELISA) detection of BDNF and the NT-3. Using SPSS17.0statistical software for analysis, measurement datas using x±D, count datas using percentage, using independent sample t-test and single factor variance analysis between mean comparison, using x2test in the comparison of structure, using the partial correlation analysisin in correlation analysis, using linear regression analysis and covariance analysis in trend test, P<0.05was considered a significant difference.共病Result:1. The incidence of depression was64%, anxiety was33.3%, the comorbidity was25.4%,28.1%of mild depression, moderate depression, severe depression,25.4%and10.5%,22.8%mild anxiety,7.9%of moderate anxiety,2.6%of severe anxiety in hemodialysis patients.2. The hemoglobin, albumin, total protein, calcium, phosphorus, cholesterol levels in MHD group were lower than that of normal control group, of hemoglobin, albumin and calcium levels in MHD depression groupwere below the non-MHD depression group, the difference was statistically significant.The NT3levels of MHD depression groupwas higher than normal control group and non-MHD group, BDNF level of MHD depression group is lower than the normal control group, the difference was statistically significant.3. The hemoglobin, albumin, total protein, calcium, phosphorus, cholesterol levels in MHD anxietyand non-anxiety group were lower than that of normal control group, c-reactive protein levels higher than the normal control group, the difference was statistically significant.4.The influencing factors of depression were hemoglobin (OR=0.948,95%CI0.908-0.990), BDNF(OR=0.907,95%CI:0.847-0.972)、NT3(OR=26.243,95%CI:5.445-126.486),when Logistic regression analysis was used, depression and anxiety as dependent variable, age, dialysis duration, marriage, income, hemoglobin, albumin, urea nitrogen, creatinine, c-reactive protein, promote the parathyroid hormone, BDNF, NT3as independent variables.Conclusion:1. The incidences of MHD patients with depression, anxiety were significantly higher than normal people.2. The general nutritional status was poor in the MHD patients with depression, anxiety.3. Depression influence factors in in the MHD patients were hemoglobin and BDNF and the NT-3, BDNF and the NT-3meaningful for diagnosis of depression disorders; The influencing factors of anxiety were NT-3, BUN, CRP, the NT-3may be a significant help in the biological diagnosis of anxiety.4. We should reduce the occurrence of depression and anxiety by improving patients nutrition and actively treating end-stage renal failure complications.5. When patients receiving hemodialysis treatment, the medical personnel should not only consider the patient’s survival, but also actively assess and diagnose the patient’s mental state, giving corresponding intervention in time to improve MHD patients life quality. |
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