类风湿关节炎患者抑郁情况及与疾病活动度相关性分析  

Correlation between depression and disease activity in patient with rheumatoid arthritis

作　　者：韩晓蕾[1] 石磊[2] Han Xiaolei;Shi Lei

机构地区：[1]山西医科大学第二医院精神卫生科,太原030001 [2]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中国药物与临床》2019年第11期1768-1770,共3页Chinese Remedies & Clinics

基　　金：山西省回国留学人员科研资助项目(2016-124)

摘　　要：目的本研究探讨类风湿关节炎(RA)患者抑郁水平及其与RA疾病活动度相关性分析。方法收集2018年6月至10月于山西医科大学第二医院风湿免疫科住院的80例RA患者。采用健康评估问卷(HAQ)和28个关节疾病活动度评分(DAS28)评估RA病情活动度。采用贝克抑郁量表第2版(BDI-Ⅱ)测量抑郁严重程度。依据HAQ及DAS28评分高低,分析RA患者抑郁程度与疾病活动度间的关系。结果80例RA患者中,女性62例(78%),男性18例(22%)。患者年龄(50±12)岁,病程(5.8±4.1)年;红细胞沉降率(38±24)mm/h;C反应蛋白(14±5)mg/L;BMI(27.8±2.2)kg/m^2;DAS28评分(4.4+1.3)分;类风湿因子(RF)100%阳性。RA患者中患有不同程度抑郁患者有52例,占65%。其中,轻度、中度和重度抑郁症分别为18例(22%)、20例(25%)和14例(18%)。高度病情活动组的VAS评分、BDI-Ⅱ评分以及HAQ评分均高于低度和中度病情活动组,且均与RA病情活动度呈正相关(P<0.05)。HAQ与BDI-Ⅱ评分(r=0.35,P=0.001)呈正相关。结论本研究中约有65%(52/80)的RA患者合并有抑郁症,且RA的疾病活动度与抑郁程度间有明显相关性。临床上积极联系精神卫生科对RA患者行抑郁筛查是必要的,帮助医生慢病管理同时,更好地帮助患者恢复身心健康。Objective To determine the level of depression in patients with rheumatoid arthritis(RA)and its relationship with the disease activity of RA.Methods Eighty RA patients admitted to the department of rheumatology and immunology in the Second Hospital of Shanxi Medical University between June 2018 and October 2018 were included as the subjects in the study.The severity of depression was measured by Baker Depression Scale-Ⅱ(BDI-Ⅱ).According to the scores of Health Assessment Questionnaire(HAQ)and 28 Joint Disease Activity Score(DAS28),the relationship between the severity of depression and disease activity in RA patients was analyzed.Results Among 80 RA patients,62 were female(78%)and 18 were male(22%).The average age of patients was(50±12)years old,and the average course of disease was(5.8±4.1)years.The average sedimentation rate of erythrocyte was(38±24)mm/h;the average level of C-reactive protein was(14±5)mg/L;the average BMI was(27.8±2.2)kg/m^2;the average score of DAS28 was(4.4±1.3)points;and the RF was 100%positive.There were 52 RA patients with different degrees of depression,accounting for 65%.Among them,there were 18(22%),20(25%)and 14(18%)patients with mild,moderate and severe depression,respectively.The VAS,BDI-Ⅱand HAQ scores in the high-grade disease activity group were higher than those in the low-grade and moderate-grade disease activity group,and were positively correlated with RA disease activity(P<0.05).HAQ score was positively correlated with BDI-Ⅱscore(r=0.35,P=0.001).Conclusion Approximately 65%(52/80)of RA patients in this study are diagnosed with depression,and there is a significant correlation between the disease activity of RA and the degree of depression.It is necessary to actively perform depression screening for RA patients in the department of mental health,which favors the management of chronic diseases,so as to support the recovery of physical and mental health in patients.

关 键 词：关节炎 类风湿 抑郁症 疾病活动度 

分 类 号：R593.22[医药卫生—内科学] R749.4[医药卫生—临床医学]