风湿性疾病伴发心理症状的临床分析  

Clinical analysis of psychological problems in patients with rheumatic diseases

作　　者：罗小萌[1] 刘盈[2] 肖卫国[1] Luo Xiaomeng Liu Ying Xiao Weiguo(Department of Rhumatology and Immunology, the First Hospital of China Medical University, Shenyang 110000, China)

机构地区：[1]中国医科大学附属第一医院风湿免疫科,沈阳110000 [2]中国医科大学附属第一医院精神医学科,沈阳110000

出　　处：《中华风湿病学杂志》2017年第7期475-479,共5页Chinese Journal of Rheumatology

摘　　要：目的分析风湿性疾病患者异常心理症状及相关因素。方法对381例风湿性疾病患者应用一般情况调查表、焦虑自评量表（SAS）、抑郁自评量表（SDS）、症状自评量表（SCL-90）、艾森克人格问卷（EPQ）进行测评，采用t检验、Speartnan回归分析等统计学方法进行分析。结果焦虑患者137例（占36．0％），抑郁患者183例（占48．0％）。性别（r=0．87，OR=2．34）、病程（r=0．006，OR=0．006）是抑郁的危险因素；而补体C4（r=-2．63，OR=0．07）是抑郁的保护因素。在SLE中，抑郁与教育程度（Z=2．228，P=-0．026）、病程（Z=-2．015，P=0．044）、免疫球蛋白（Ig）G（t=-2．266，P=0．027）、T细胞亚群CD8（Z=1．981，P=0．047）、CD3（Z=1．967，P=0．049）细胞数有关；焦虑与教育程度（Z=2．452，P=0．014）、病程（Z=2．243，P=0．028）、CRP（Z=1．984，P=0．047）有关。SS患者抑郁与病程（Z=-2．631，P=0．009）、性别（χ2=4．415，P=0．042）、ESR（Z=2．17，P=0．023）、CD3细胞数（Z=2．023，P=0．043）有关。抑郁与EPQ量表中E维度（外向）（r=-0．23，P=0．01）呈负相关，与P维度（精神质）（r=0．21，P=0.01）、N纬度（神经质）（r=0．52，P=0．01）呈正相关；焦虑与E维度呈负相关（r=-0．14，P=0．006）；P维度（r=0．14，P=0．007）、N维度（r=0．55，P=0．007）呈正相关。结论风湿性疾病患者常伴发抑郁、焦虑。这与年龄、女性性别、病程、补体、免疫球蛋白、T细胞亚群等有密切关系；内向性格、情绪不稳定、神经质的患者更易出现抑郁、焦虑。因此，应重视风湿性疾病患者的心理症状，尽早评估及治疗。Objective To study the mental status and its influencing factors of patients with rheumatic disease. Methods Three hundreds and eighty-one patients with rheumatic diseases were assessed with the self-rating anxiety scale, self-rating depressive scale, Eysenck Personality Questionnaire symptom checklist- 90, and demographic characteristics questionnaire. The comparison among groups were tested by t tests, Spearman＇s correlation analysis. Results Patients with anxiety symptoms accounted for 35.96%, and pre- valence rate of depression was 48.03%. The gender （r=0.87, OR =2.34） and duration （r=0.006, OR =1.006） were the risk factors and the C4 （r=-2.63, OR=0.07） was the protective factor. In patients with systemic lupus erythematosus, depression was related to education （Z=2.228, P=0.026）, disease duration （Z=-2.015,P=0.044）, IgG level （t=-2.266, P=0.027）, T cell subsets CD8 （Z=1.981, P=0.047） and CD3 （Z=1.967, P=0.049）. Anxiety was related to education （Z=2.452, P=0.014）, duration （Z=-2.054, P=0.04）, complement C3 （t=2.035, P=0.045）, C4 （Z=-2.204, P=0.028） and IgG level （t=-2.126, P=0.036）. The value of CRP（Z=-1.984, P=0.047） and IgM （t=2.243, P=0.028） of rheumatoid arthritis patients were higher in the depression group. The depression group was different in disease duration （Z=-2.631, P=0.009）, gender （χ2=4.415, P=0.042）, ESR （Z=2.17, P=0.023） and CD3 cell （Z=2.023, P=0.043） in Sjogren＇s syndrome patients. Correlation analysis showed positive correlation between the score of SDS, SAS and the P value （r=0.21, P=0.0t） （r=0.14, P=0.007） N dimension （r=0.52, P=0.01） （r=0.55, P=0.007） of EPQ. There were negative correlation between the score of SDS, SAS and the E dimension （r=-0.23, P=0.01） （r=-0.14, P=0.006） of EPQ. Conclusion The prevalence of depres- sion and anxiety is higher in patients with depressive and anxious symptoms. They are in older age, female gender, poor education, longer duration, lower complement an

关 键 词：风湿性疾病 抑郁 焦虑 人格 影响因素 

分 类 号：R593.2[医药卫生—内科学]