APACHE Ⅱ评分与老年宫颈癌及卵巢癌患者术后焦虑状态或抑郁状态的相关性分析  

Correlation Analysis of APACHE Ⅱ Score of Postoperative Elderly Patients with Cervical and Ovarian Cancer and Anxiety State or Depression State

作　　者：张琛[1] 王春瑛[1] 王影[1] Zhang Chen;Wang Chunying;Wang Ying(Affiliated Hospital of Chengdu University,Chengdu,Sichuan 610081,China)

机构地区：[1]成都大学附属医院

出　　处：《四川医学》2019年第5期495-499,共5页Sichuan Medical Journal

摘　　要：目的 探讨急性生理与慢性健康状况评分II(APACHE II)与宫颈癌、卵巢癌术后患者焦虑状态或抑郁状态的相关性。方法连续纳入275例老年宫颈癌、卵巢癌术后患者,所有患者均于术后48小时内行APACHE II评分,于出院后3个月分别以焦虑量表(SAS)和抑郁量表(SDS)对其心理状态进行评估,根据有无焦虑状态或抑郁状态,将患者分为正常组和异常组。采用logistic回归分析探讨APACHE II评分与焦虑状态或抑郁状态的相关性,采用ROC曲线分析APACHE II对焦虑状态或抑郁状态的预测效能。结果两组间比较显示:异常组在化疗疗程≥2个疗程、合并糖尿病及慢性阻塞性肺病、离异或丧偶、家庭年收入<1万等情况发生率显著高于正常组( P <0.05)。APACHE II评分在异常组得分显著高于正常组(14.7±3.1 vs 8.5±2.4, t =17.50, P <0.001)。多因素logistic回归分析显示在校正化疗疗程、慢性疾病及收入等状况后APACHE II评分仍然是焦虑状态或抑郁状态的独立预测因素( OR =3.075,95% CI 1.841~5.275, P <0.001)。通过ROC曲线分析显示APACHE II评分对术后焦虑状态或抑郁状态具有良好的判断价值( AUC =0.81,95% CI :0.72~0.91, P <0.001)。结论老年宫颈癌、卵巢癌患者术后焦虑状态或抑郁状态发生率较高。APACHE II评分是该类患者焦虑状态或抑郁状态的独立预测因素,在指导临床中提前风险评估、分层干预、改善患者心理健康状态和生活质量方面具有重要价值。Objective To investigate the correlation between acute physiology and chronic health score II(APACHE II)and anxiety or depression in elderly patients with cervical and ovarian cancer after operation. Methods 275 consecutive elderly patients with cervical and ovarian cancer were enrolled.APACHE II was scored within 48 hours after operation.Their psychological status was assessed by SAS and SDS respectively three months after discharge.The patients were divided into normal group and abnormal group according to the presence or absence of anxiety or depression.Logistic regression analysis was used to explore the correlation between APACHE II score and anxiety and depression.ROC curve was used to analyze the predictive efficacy of APACHE II on anxiety and depression. Results The comparison between the two groups showed that the incidence of abnormal group was significantly higher than that of normal group( P <0.05)in the course of chemotherapy(>2 courses),diabetes mellitus and chronic obstructive pulmonary disease(COPD),divorce or widowhood,and annual family income(<10,000 RMB).APACHE II score in the abnormal group was significantly higher than that in the normal group(14.7±3.1 vs 8.5±2.4, t =17.50, P <0.001).Multivariate logistic regression analysis showed that APACHE II score was still an independent predictor of anxiety or depression(OR=3.075,95% CI 1.841~5.275, P <0.001)after adjusting for chemotherapy course,chronic diseases and income.ROC curve analysis showed that APACHE II score had a good value in judging anxiety and depression after operation(AUC=0.81,95% CI:0.72~0.91, P <0.001). Conclusion The incidence of anxiety and depression in elderly patients with cervical and ovarian cancer is higher.APACHE II score is an independent predictor of anxiety and depression in these patients.It has important value in guiding clinical risk assessment,stratified intervention,improving mental health and quality of life of patients.

关 键 词：急性生理与慢性健康状况评分II 宫颈癌 卵巢癌 焦虑状态 抑郁状态 

分 类 号：R737.33[医药卫生—肿瘤]