Effect of hyperbaric oxygen therapy on the cognitive function in uremic patients with maintenance hemodialysis
10.3760/cma.j.cn311847-20210709-00200
- VernacularTitle:高压氧治疗对维持性血液透析尿毒症患者认知功能的影响
- Author:
Congdie LIANG
1
;
Liming ZHANG
1
Author Information
1. 上海市闸北中心医院肾内科，上海 200070
- Publication Type:Journal Article
- Keywords:
Uremia;
Hemodialysis;
Hyperbaric oxygen;
Cognitive function;
MoCA
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2022;29(2):193-197
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of hyperbaric oxygen（HBO）therapy on the cognitive function in uremic patients with maintenance hemodialysis.Methods:The uremic patients undergoing maintenance hemodialysis in the Department of Nephrology of Zhabei Central Hospital from January 2020 to December 2020 were selected as the research subjects. The Chinese version of Montreal Cognitive Assessment（MoCA）was used to assess the cognitive function of all patients. Eighty-two patients with cognitive dysfunction were identified according to their length of education and MoCA total scores，and were divided into HBO group and control group according to the random number table method，with 41 patients in each group. Patients in the control group were given treatment such as correction of water-electrolyte disturbance，nutritional support，and hemodialysis，while patients in the HBO group were additionally given HBO treatment on the basis of the treatment in the control group. The clearance of toxins，levels of inflammatory factors，cognitive function，and quality of life were compared between the two groups.Results:After treatment，the total scores and factor scores of MoCA，and the total mean scores and factor scores of kidney disease-targeted areas（KDTA）of the HBO group were significantly higher than those of the control group（ P < 0.05）. In the HBO group，the scores of executive ability，abstraction，orientation，language，naming，and attention，and the total scores of MoCA after treatment were significantly increased when compared with those before treatment；in the control group，only the scores of orientation and attention and the total scores of MoCA after treatment were significantly increased（ P < 0.05）. All factor scores and total mean scores of KDTA in both groups were increased significantly（ P < 0.05），except for the score of effects of kidney disease（EKD）in the control group. The clearance rates of blood creatinine（Cr），urea nitrogen（BUN），parathyroid hormone（PTH），β2-microglobulin（β2-MG）and cysteine protease inhibitor C（CysC）in the HBO group were significantly higher than those of the control group（ P<0.05）. And the levels of serum C-reactive protein（CRP），interleukins（IL-6，IL-8），tumor necrosis factor-α（TNF-α），and monocyte chemotactic protein-1（MCP-1）in both groups after treatment were lower than those before treatment，and levels of inflammatory factors in the HBO group were significantly lower than those in the control group，with statistically significant differences（ P < 0.05）. Conclusion:HBO therapy helps remove toxins in uremic patients with maintenance hemodialysis，reduce inflammatory response，and improve the cognitive function and quality of life to a certain extent.
