【摘要】

目的 探讨维持性血液透析患者认知功能障碍影响因素及与血清Klotho蛋白的关系研究。
方法：选取2017年3月到2019年10月在四川大学华西医院雅安医院维持性血液透析患者198人。收集患者临床相关指标及实验室相关指标，利用蒙特利尔评分法进行认知功能评分，根据评分分为认知功能障碍组及认知功能正常组。检测血清Klotho蛋白浓度。
结果：认知损害组患者年龄较认知正常组偏大（P<0.05），大专以上学历占比及脑力劳动者占比较认知正常组低（P均<0.05），认知损害组患者高血压、糖尿病占比较认知正常组患者较高（P均<0.05）。认知损害组患者透析后平均动脉压较认知正常组低（P均<0.05）。认知损害组患者平均血红蛋白浓度较认知正常组患者低（P<0.05），甲状旁腺素水平较认知正常组患者高（P<0.05），C反应蛋白水平较认证正常组患者高（P<0.05）。血清Klotho蛋白浓度与蒙特利尔评分呈正相关（R=1.32,P<0.05）。
结论：维持性血液透析患者普遍存在着认知功能功能障碍，同时认知功能障碍与患者年龄、教育程度、高血压、糖尿病、血红蛋白水平、C反应蛋白水平及甲状旁腺激素水平有关。血清Kloho浓度降低与患者认知功能相关。

【Abstract】

Obiective To explore the relationship between cognitive dysfunction and serum Klotho protein in maintenance hemodialysis patients.
Methods: 198 maintenance hemodialysis patients in Ya'an people’s hospital from March 2017 to October 2019 were selected. The patients were divided into cognitive dysfunction group and normal cognitive function group according to the Montreal score. Serum Klotho protein concentration was detected.
Results:The age of the cognitive impairment group was older than that of the normal cognitive group (P < 0.05), the proportion of college education and mental workers was lower than that of the cognitive normal group (P < 0.05). The proportion of hypertension and diabetes mellitus in the cognitive impairment group was higher than that in the cognitive normal group (P < 0.05). The mean arterial pressure in the cognitive impairment group was lower than that in the cognitive normal group (P < 0.05). The average hemoglobin concentration of cognitive impairment group was lower than that of cognitive normal group (P < 0.05), parathyroid hormone level was higher than that of cognitive normal group (P < 0.05), and C-reactive protein level was higher than that of certified normal group (P < 0.05). Serum Klotho protein concentration was positively correlated with Montreal score (r = 1.32, P < 0.05).
Conclusion  : cognitive dysfunction is common in maintenance hemodialysis patients, and cognitive dysfunction is related to age, education level, hypertension, diabetes, hemoglobin level, C-reactive protein level and parathyroid hormone level. The decrease of serum kloho concentration is related to cognitive function.