nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2020-24-4-67-72nefr-1860Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSПоказатели нейродинамики и внимания у пациентов с терминальной стадией хронической болезни почек. Влияние процедуры гемодиализаIndicators of neurodynamics and attention in patients with the end stage kidney disease. Influence of hemodialysis procedureshttps://orcid.org/0000-0003-0304-4263СмакотинаС. А.SmakotinaS. A.

Проф. Смакотина Светлана Анатольевна, д-р мед. наук, кафедра факультетской терапии, профессиональных болезней и эндокринологии

650029, г. Кемерово, ул. Ворошилова, д. 22А

Тел.: +7(903)993-00-41

Prof. Svetlana A. Smakotina, MD, PhD, DMedSci, professor of faculty therapy chair, professional disease and endocrinology

650029, Kemerovo, Voroshilova st., 22a

Phone: +7(903)993-00-41

smak67@mail.ruhttps://orcid.org/0000-0002-9375-4578БохановЮ. А.BohanovY. A.

Боханов Юрий Александрович, врач-нефролог

650000, г. Кемерово, ул. Володарского, д. 16

Yrii A. Bohanov, MD, nephrologist

650000, Kemerovo, Volodarskogo st., 16 

Northshining@gmail.comhttps://orcid.org/0000-0003-2139-5446ФоминаН. В.FominaN. V.

Фомина Наталья Викторовна, д-р мед. наук, кафедра факультетской терапии, профессиональных болезней и эндокринологии, заведующая

650056, г. Кемерово, ул. Ворошилова, д. 22А

Natalia V. Fomina, MD, PhD, DMedSci, Head of the Department of Faculty Therapy, professional disease and endocrinology 

650029, Kemerovo, Voroshilova st., 22a

natafomin11@mail.ruКемеровский государственный медицинский университетРоссияKemerovo state medical academyRussian FederationМедицинский центр «Родник»РоссияMedical center «Rodnik»Russian Federation2020260620202446772Copyright © Смакотина С.А., Боханов Ю.А., Фомина Н.В., 20202020Смакотина С.А., Боханов Ю.А., Фомина Н.В.Smakotina S.A., Bohanov Y.A., Fomina N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1860

ЦЕЛЬ ИССЛЕДОВАНИЯ. Сравнить показатели когнитивных функций у пациентов с хронической болезнью почек (ХБП)  С5, не получающих гемодиализ (ГД), и пациентов на ГД. Оценить влияние процедуры гемодиализа на когнитивные функции. ПАЦИЕНТЫ И МЕТОДЫ. В исследование включены пациенты молодого и среднего возраста (от 18 до 60 лет) (n=40), имеющие терминальную стадию хронической болезни почек (ХБП), и 40 пациентов на ГД (от 18 до 58 лет), составляющих группу сравнения. Критерием исключения для обеих групп были: наличие в анамнезе заболеваний центральной нервной системы; травма головного мозга; эпизоды нарушений мозгового кровообращения различной степени выраженности; ишемическая болезнь сердца; хроническая сердечная недостаточность; беременность; злоупотребление алкоголем; отказ от участия в исследовании. Когнитивные нарушения оценивались с помощью программного комплекса Status PF. РЕЗУЛЬТАТЫ. Все пациенты, прошедшие обследование на программном комплексе Status PF, имели нарушения когнитивных функций по показателям нейродинамики, внимания, памяти. Были получены статистически значимые различия с группой сравнения. Процедура гемодиализа ухудшает когнитивные функции. ЗАКЛЮЧЕНИЕ. Пациенты с терминальной стадией ХБП имеют когнитивный дефицит. Процедура ГД ухудшает когнитивные функции. После диализа пациенты демонстрировали большее время реакции и психомоторное замедление. Уровень средней экспозиции ПЗМР в группе без ГД составил 359,4±48,84 мс, в группе ГД – 381,1±63,34 мс (р=0,04). Средняя экспозиция СЗМР у пациентов до проведения процедуры – 515,57±83,89 мс, после ГД данный показатель был ниже – 498,87±80,8 (р=0,036).

THE AIM. Compare cognitive performance in patients with CKD not receiving HD and patients on HD. PATIENTS AND METHODS. The study included patients of young and middle age (from 18 to 60 years) (n = 40) who have stage 5 of chronic kidney disease (CKD) and 40 patients on hemodialysis of comparable age (from 18 to 58 years) who make up the comparison group. The exclusion criteria for both groups were: a history of diseases of the central nervous system; brain injury; episodes of cerebral circulation of varying severity; coronary heart disease; chronic heart failure; pregnancy; alcohol abuse; refusal to participate in the study. Cognitive impairments were assessed using the Status PF software package. RESULTS. All patients were examined with software package Status PF. They demonstrated light cognitive dysfunctions in neurodynamics, memory, and attention indices. The differences in indices were statistically significant with the experimental group. CONCLUSION. In patients of young and middle age with 5 stages of CKD, the use of modern software complex Status PF allows us to diagnose mild cognitive impairment. After dialysis, patients showed greater response time and psychomotor slowdown. The average exposure level of SHER in the group without HD was 359.4 ± 48.84 msec, in the group of HD – 381.1 ± 63.34 msec (p = 0.04). The average exposure to CHER in patients before the procedure was 515.57 ± 83.89 ms, after HD, this figure was lower – 498.87 ± 80.8 (p = 0.036).

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The authors declare that there are no conflicts of interest present.