维持性血液透析患者抑郁患病率的meta分析

李兰 温贤秀 夏琪 肖力 谢林娟

【摘要】 目的  系統评价中国维持性血液透析患者抑郁患病率现状。

方法  通过计算机检索Pubmed、Cochrane Library、Web of Science、Embase、中国知网（CNKI）、万方数据库（Wanfang Data）、中国生物医学文献数据（CBM）、维普（VIP）数据库，收集国内外截至2020年12月发表的有关中国维持性血液透析患者抑郁患病情况的调查研究，应用Stata 12.0软件进行Meta分析。

结果  共纳入22个横断面研究，包括2769例维持性血液透析患者，发生抑郁的患者1406例。Meta分析结果显示，我国维持性血液透析患者抑郁患病率为51.4%[95% CI （47.7%～55.1%）]。亚组分析结果显示，女性患病率高于男性，无配偶患者患病率高于有配偶患者，高中以上文化水平患者患病率高于高中及以下文化水平患者、有并发症患者患病率高于无并发症患者、南方患者患病率高于北方患者。

结论  我国维持性血液透析患者抑郁患病率较高，应引起更多的关注，及时发现抑郁高危人群及影响因素，减少维持性血液透析患者抑郁的发生。

【关键词】  血液透析;抑郁;患病率;Meta分析

中图分类号： R749.4+1;R692.5    文献标志码： A    DOI： 10.3969/j.issn.1003-1383.2021.08.002

Prevalence of depression in maintenance hemodialysis patients：a meta-analysis

LI Lan1， WEN Xianxiu2a， XIA Qi2b， XIAO Li2a， XIE Linjuan1

（1. School of Nursing， Chengdu University of TCM， Chengdu 610075， Sichuan， China; 2a. Nursing Department，  2b. PICC Center， Sichuan Provincial People's Hospital， Chengdu 610072， Sichuan， China）

【Abstract】 Objective  To systematically evaluate the prevalence of depression in maintenance hemodialysis patients in China.

Methods  Pubmed， Cochrane Library， Web of Science， Embase， CNKI， Wanfang Data， CBM， and VIP database were systematically searched by computer to collect investigations and researches of the prevalence of depression in Chinese maintenance hemodialysis patients published at home and abroad as of December 2020. Meta-analysis was performed by using Stata 12.0 software.

Results  A total of 22 cross-sectional studies were included， including 2769 maintenance hemodialysis patients， of which 1406 with depression. Meta-analysis results showed that the overall prevalence of depression in China was 51.4% （95%  CI  [47.7% - 55.1%]）. Subgroup analysis showed that the prevalence of females was higher than that of males， the prevalence of patients without spouse was higher than that of patients with spouse， the prevalence of patients with high school education level or above was higher than that of patients with high school education level or below， the prevalence of patients with complications was higher than that of patients without complications， and the prevalence of patients in the south was higher than that in the north.

Conclusion  The prevalence of depression in maintenance hemodialysis patients in China is high， more attention should be paid to this situation. High-risk groups and influencing factors of depression should be found out in time to reduce the incidence of depression in maintenance hemodialysis patients.

【Key words】  hemodialysis; depression; prevalence; meta-analysis

慢性肾脏病（CKD）是一个公认的世界性卫生问题，据《柳叶刀》2017年调查数据显示，中国CKD约有3.2亿[1]。血液透析是终末期肾病患者延续生命的重要方法之一，是临床应用率最高的肾脏替代方法。尽管血液透析提高了患者的生存率，但长期血液透析患者精神障碍发生率高，其中抑郁是血液透析患者中最常见的精神障碍[2]。抑郁可能会增加患者的病死率、住院率，影响患者的食欲，降低血液透析患者的生存质量等[3]。……