维持性血液透析患者认知功能特点研究

Objective: To study the episodic memory, semantic memory, cognitive planning ability and inhibition ability in MHD patients. Method: Neuropsychological research methods such as Action memory of verb-object phrase, Trail Making Test (A and B), Verbal Fluency Test, Go-No/Go test and Stroop Color Naming Task were used to investigate Episodic Memory 、Semantic Memory、Executive Function of 40 MHD and 40 NC. Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale(SDS), Social Support Scale, Life Satisfaction Scale, and biochemical examination were applied and their relationships with cognitive function were analized. The mean age and education level of MHD group and NC group have no significant difference. Result: 1.Action memory of verb-object phrase differed significantly between MHD group and NC group. 2.Two tests of Verbal Fluency differed significantly between MHD group and NC group. 3.Trail Making Test A, Trail Making Test B, the baseline condition of Go-No/Go Test and Stroop Color Naming Test differed significantly between MHD group and NC group. 4.There is no significant difference between MHD group and NC group on the correct rate of No/Go Test and the baseline condition. Both groups showed Stroop Effect in Go-No/Go test, but MHD group performed significantly worse. 5.In Stroop Color Naming Task Test, NC group showed Stroop Effect, significant Repeated Distraction Promotion Effect and significant Negative Priming Effect,while MHD group showed only Stroop Effect and no Repeated Distraction Promotion Effect and no Negative Priming Effect. There is significant difference in Stroop Effect between MHD group and NC group. Conclusion: 1.Comparing with NC group, episodic memory, semantic memory, cognitive planning ability, and inhibition ability of MHD group were impaired significantly. 2.The pathological aging of Executive Function in MHD group showed: executive Function should be a unitary system. 3.Cognitive impairment is negatively correlated with serum creatinine, blood pressure and anxiety score in MHD patients; and is related with hemoglobin, hematocrit, social support and life satisfaction. Keyword: maintenance hemodialysis, episodic memory, semantic memory, cognitive planning, inhibition ability.

目的：探讨维持性血液透析患者（maintenance hemodialysis, MHD ）认知功能特点。 方法：采用动作记忆、词语流畅性测验(Verbal Fluency Test)、连线测验(Trail Making Test)、Go-No/Go测验、Stroop颜色命名测验(Stroop Color Naming Task)等指标,比较40名MHD患者和40名正常人（Normal Control，NC）的情节记忆、语义记忆、认知计划能力及抑制能力。运用SAS、SDS及社会支持和生活满意度量表和生化检查，分析其与认知功能的相关性。MHD组和NC组的平均年龄和受教育程度均无显著差异。 结果： 1.MHD组的动作记忆成绩显著差于NC组。 2.MHD组的词语流畅性测验成绩显著差于NC组。 3.MHD组的连线测验A、连线测验B、Go-No/Go测验基线水平及Stroop颜色命名测验中性条件的成绩显著差于NC组。 4.Go-No/Go测验中的No/Go 和基线水平正确率在两组中没有显著差异。两组被试均表现出显著的Stroop 干扰效应，MHD组的干扰效应更明显。 5.Stroop色字测验中，NC组表现出显著的Stroop 效应、重复分心物促进效应和负启动效应；而MHD组只有Stroop 效应显著，后两者皆不显著。两组的Stroop 效应差异显著。 结论： 1.MHD组的动作记忆、语义记忆、认知计划能力、抑制能力显著差于NC组。 2.MHD患者工作记忆的计划功能和抑制功能一致受损。 3．MHD患者的认知功能损伤与血肌酐、血压、焦虑评分呈负相关；与血红蛋白、红细胞压积、社会支持和生活满意度呈正相关。 关键词：血液透析患者，情节记忆、语义记忆、计划能力、抑制能力