目的探讨慢病管理对慢性肾脏病3～4 期患者营养和焦虑抑郁的影响。方法采用便利抽样法，抽取71 名患者接受营养和焦虑抑郁的评估，然后由专科护士6 个月后对患者进行后测，并使用配对样本t 检验比较慢病管理对患者营养和焦虑抑郁改善的有效性。结果患者血尿素氮(t=3.325，P=0.001)、焦虑(t=2.026，P=0.047)和抑郁(t=3.571，P=0.001)水平较实施慢病管理前有显著下降，血白蛋白(t=-2.035，P=0.046)和血钙(t=-2.328，P=0.023)水平则有显著提升。结论对3～4 期患者实行慢病管理，改善患者营养不良和焦虑抑郁状况。

Objective To evaluate the effect of care model for chronic diseases on nutritional status, anxiety and depression in patients with chronic kidney disease at stage 3 or 4. Methods A total of 71 stage 3 to 4 chronic kidney disease patients chosen with convenience sampling method accepted the evaluation of nutrition status ,anxiety and depression. Then the professional nurse offered chronic care model nursing for them. After 6 months, we gave the patients aftertest, and manipulated paired-sample T test to explore the effect of chronic care model on patients’nutritional status, anxiety and depression. Result The urea nitrogen(t=3.325, P=0.001), anxiety(t=2.026,P=0.047) and depression(t=3.571,P=0.001) of patients were significantly lower after the intervention, and their blood albumin (t=-2.035, P=0.046) and blood calcium (t=-2.328,P=0.023) were significantly improved. Conclusion Chronic care model can significantly improve CKD3-4 stage patients’nutritional status and their anxiety, depression.