中青年维持血液透析患者氧化三甲胺与轻度认知功能损害相关性临床研究

doi:10.3969/j.issn.1004-583X.2019.11.006

临床荟萃

中青年维持血液透析患者氧化三甲胺与轻度认知功能损害相关性临床研究

桂林市人民医院肾内科，广西桂林 541002

出版日期:2019-11-20 发布日期:2020-01-09
通讯作者: 卢岚，Email: lulande@sina.com

Clinical study on the relationship between trimethylamine NOxide and mild cognitive impairment in young and middleaged patients with maintenance hemodialysis

Department of Nephrology, Guilin People's Hospital, Guilin 541002, China

Online:2019-11-20 Published:2020-01-09
Contact: Corresponding author: Lu Lan, Email: lulande@sina.com

摘要/Abstract

摘要： 目的探讨中青年维持血液透析（MHD）患者轻度认知功能损害（MCI）与氧化三甲胺（TMAO）的相关性。方法选取本院 2016年6月至 2018年6月收治的中青年MHD患者108例为研究对象。采用应用简易智力状态检查量表和蒙特利尔认知评估表 (MoCA)评价患者的认知功能，调查入选患者的临床资料及实验室指标，通过高效液相色谱串联质谱法测定TMAO 水平，分析TMAO与MCI的关系。结果 108例中青年MHD患者中MCI者50例，患病率46.3%，与非MCI组相比，MCI组男性、透析龄长、合并糖尿病患者比例高，三酰甘油(TG) 、低密度脂蛋白胆固醇(LDLC)、尿酸(UA)、C反应蛋白(CRP)及TMAO水平高，初中以上患者比例低（P＜0.05）。MoCA积分与透析龄、糖尿病、TMAO呈负相关，与受教育程度呈正相关(r=-0.402、-0.216、-0.416、0.389，P＜0.05)。高龄、长透析龄及TMAO增高是中青年MHD患者发生MCI的独立危险因素, 高教育水平为其保护因素。结论中青年MHD患者MCI发生率较高，TMAO增高为MCI的独立危险因素。

关键词: 肾透析, 轻度认知障碍, 氧化三甲胺

Abstract: Objective To investigate the relationship between trimethylamine N-Oxide(TMAO) and mild cognitive impairment (MCI)in young and middleaged patients with maintenance hemodialysis(MHD). Methods Totally 108 cases of young and middleaged MHD patientsadmitted to the hospital from June 2016 to June 2018 were selected as subjects. Simple intelligence state examination scale and Montreal cognitive assessment(MoCA) scale were used to evaluate patients' cognitive function, and investigate the clinical data and laboratory indicators of selected patients, TMAO levels were measured by highefficiency liquid chromatography series mass spectrometry, and the correlation between TMAO and MCI was also analyzed.Results Among 108 young and middleaged MHD patients, totally 50 cases suffered from MCI,which was accounted for 46.3%. Compared with the nonMCI group, the proportion of male, dialysis age, combined diabetes, TG, LDL, UA, CRP and TMAO were higher, the proportion of middle school patients above the education was lower(P<0.05). MoCA integrals were negatively correlated with dialysis age, diabetes, and TMAO, and they were positively correlated with educational attainment (r=-0.402, -0.216, -0.416, 0.389, P＜0.05). The elderly, long dialysis age and increase of TMAO were independent risk factors for the occurrence of MCI in young and middleaged MHD patients, while the high education level was a protective factor.Conclusion The incidence of MCI was higher in young and middleaged MHD patients, and the increase of TMAO was an independent risk factor for MCI.

Key words: renal , dialysis；mild , cognitive impairment；trimethylamine NOxide

朱昭章, 周凡力, 卢岚. 中青年维持血液透析患者氧化三甲胺与轻度认知功能损害相关性临床研究[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.11.006.

Zhu Zhaozhang, Zhou Fanli, Lu Lan. Clinical study on the relationship between trimethylamine NOxide and mild cognitive impairment in young and middleaged patients with maintenance hemodialysis[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.11.006.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2019.11.006

https://huicui.hebmu.edu.cn/CN/Y2019/V34/I11/991

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中青年维持血液透析患者氧化三甲胺与轻度认知功能损害相关性临床研究

Clinical study on the relationship between trimethylamine NOxide and mild cognitive impairment in young and middleaged patients with maintenance hemodialysis

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