■这项研究的目的是研究导致维持性血液透析(MHD)患者焦虑和抑郁的因素,以及它们与血清脑源性神经营养因子(BDNF)水平的关系,神经营养蛋白-3(NT-3),和5-羟色胺(5-HT)。
■在2020年5月和2022年6月,纳入了在我们医院接受MDH治疗的120例MHD患者。对照组由60名同时完成体检的健康成人(>18人)组成。血清BDNF水平,比较患者NT-3、5-HT及MHD患者不同程度焦虑抑郁的临床资料。采用Pearson相关性评价焦虑抑郁评分与血清BDNF,MHD患者的NT-3,5-HT水平。采用多因素分析MHD患者焦虑、抑郁的危险因素。
■120例MHD患者焦虑和抑郁的发生率分别为34.17%(41/120)和64.17%(77/120),分别。焦虑组血清NT-3和5-HT水平高于非焦虑组和对照组,无焦虑组血清NT-3水平高于对照组(P<0.05)。血清BDNF水平,抑郁组的NT-3和5-HT高于非抑郁组和对照组,非抑郁组血清NT-3水平高于对照组(P<0.05)。SAS评分与血清NT-3、5-HT水平呈正相关,SDS评分与血清BDNF呈负相关,与血清NT-3、5-HT水平呈正相关。女性,农村户籍,不宁腿综合征是MHD患者焦虑的独立危险变量(P<0.05)。农村户籍,经济恶化,疲劳,失眠,血管疼痛是MHD患者抑郁风险的独立变量。
■MHD患者的焦虑和抑郁情绪与血清BDNF水平密切相关,NT-3和5-HT。女性,农村户籍,超过八个透析次数/月,失眠,不宁腿综合征是MHD患者焦虑的危险因素。农村户籍,经济恶化,疲劳,失眠,血管疼痛是MHD患者抑郁的危险因素。这些发现的临床意义表明,这些指标可能是MHD患者焦虑和抑郁的生物学指标。因此,这种调查有助于早期发现,监测,并有可能描述管理这些不良状态的新治疗策略。
The aim of this study is to examine the factors that contribute to anxiety and depression in individuals undergoing maintenance hemodialysis (MHD), as well as their association with serum levels of brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3), and serotonin (5-HT).
In May 2020 and June 2022, 120 MHD patients who received MDH treatment at our hospital were enrolled. The control group was composed of 60 healthy adults (>18) who completed the physical examination at the same time. The serum levels of BDNF, NT-3, and 5-HT in patients and clinical data of MHD patients with different degrees of anxiety and depression were compared. The Pearson correlation was used to evaluate the correlation between anxiety and depression scores and serum BDNF, NT-3,5-HT levels in patients with MHD. Multivariate analysis was employed to analyze the risk factors of anxiety and depression in MHD patients.
The incidence of anxiety and depression in 120 MHD patients was 34.17% (41/120) and 64.17% (77/120), respectively. The levels of serum NT-3 and 5-HT in the anxiety group were higher than those in the non-anxiety and control group, and the levels of serum NT-3 in the non-anxiety group were higher than those in the control group (P < 0.05). The levels of serum BDNF, NT-3 and 5-HT in the depressed group were higher than those in the non-depressed group and control group, and the levels of serum NT-3 in the non-depressed group were higher than those in the control group (P < 0.05). SAS score was positively correlated with serum NT-3 and 5-HT levels, while the SDS score was negatively correlated with serum BDNF and positively correlated with serum NT-3 and 5-HT levels. Female, rural household registration, and restless leg syndrome were independent risk variables for anxiety in patients with MHD (P < 0.05). Rural household registration, economic deterioration, fatigue, insomnia, and vascular pain were independent variables of depression risk in patients with MHD.
Anxiety and depression in patients with MHD are closely related to the levels of serum BDNF, NT-3, and 5-HT. Female, rural household registration, more than eight dialysis times/month, insomnia, and restless leg syndrome are the risk factors for anxiety in patients with MHD. Rural household registration, economic deterioration, fatigue, insomnia, and vascular pain are the risk factors for depression in patients with MHD. The clinical implication of these findings suggests that these indexes may perhaps serve as biological indicators of anxiety and depression amongst patients undergoing MHD. Such investigation can hence contribute to early detection, monitoring, and potentially enable the depiction of novel therapeutic strategies for managing these adverse states.