抑郁状况对50岁以下人群结直肠息肉患病风险的影响  

The depression status and related influencing factors in patients with colorectal polyps under 50 years old

作　　者：徐俊玄 张倩 邢洁[1] 陈翌阳[2] 孙秀静[1] 焦月[1] 朱圣韬[1] 李鹏[1] 张澍田[1] XU Jun-xuan;ZHANG Qian;XING Jie(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Disease,Beijing Digestive Disease Center,Beijing Key Laboratory for Precancerous Lesion of Digestive Disease,Beijing 100050,China.)

机构地区：[1]首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心北京市消化疾病中心消化疾病癌前病变北京市重点实验室,北京100050 [2]首都医科大学附属北京友谊医院检验科,北京100050

出　　处：《临床和实验医学杂志》2021年第17期1845-1850,共6页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:81802310);北京市医院管理中心消化内科学科协同发展中心重点专项项目(编号:XXZ01,XXZ02);北京市自然科学基金(编号:7204249)。

摘　　要：目的探讨抑郁状况对50岁以下人群结直肠息肉患病风险的影响。方法采用回顾性调查研究,以2013年3月至2014年11月在首都医科大学附属北京友谊医院接受结肠镜检查的127例18~49岁人群为研究对象。以25例结直肠息肉患者作为病例组,以102例内镜检查未见异常的对象为对照组。收集研究对象的基本信息、既往史,采用流调中心抑郁量表对研究对象的抑郁状态进行评估,计算抑郁情绪、积极情绪、躯体症状与活动迟滞、人际四个维度的得分及总分。比较病例组与对照组的得分差异,并采用多因素Logistic回归模型及列线图分析影响结直肠癌前病变的相关因素。结果息肉组吸烟率为44.0%,高于对照组吸烟率13.7%,差异有统计学意义(P=0.002)。2组研究对象在年龄、性别、其他基本信息、既往患病史、饮酒率等方面的差异无统计学意义(P>0.05)。自填流调中心抑郁量表结果显示,息肉组在抑郁情绪和积极情绪两个维度及总分的分值均高于对照组,差异均有统计学意义(P=0.041、0.003、0.003)。抑郁状态中的抑郁情绪、积极情绪维度得分越高,人际得分越低,发生结直肠息肉的可能性越高[P值分别为0.049、0.005、0.045,OR值分别为1.164(95%CI:1.001~1.355)、1.243(95%CI:1.069~1.446)和0.546(95%CI:0.302~0.987)]。除抑郁外,吸烟也是结直肠息肉发生的独立危险因素(P=0.001),OR值为6.218(95%CI:2.041~18.942)。采用多因素Logistic回归模型绘制列线图,其一致性指数和曲线下面积均为0.816,灵敏度为84.0%,特异度为74.5%。结论抑郁状态可能与50岁以下结直肠息肉的发生有一定的相关性。Objective To explore the depression status and related influencing factors in patients with colorectal polyps under 50 years old.Methods Using retrospective survey research,the 127 subjects aged 18 to 49 who underwent colonoscopy in Beijing Friendship Hospital,Capital Medical University from March 2013 to November 2014 were enrolled in this study.A total of 25 patients with colorectal polyps were selected in the cases group,and 102 study subjects with normal endoscopy were selected in the control group.The demographic information and disease history of the subjects were collected.The Center for Epidemiological Studies Depression Scale(CES-D)was used to evaluate the depressive status of the research subjects.Total scores and divided scores of the four dimensions were calculated.The scores'differences between the case group and the control group were compared,and the multivariate logistic regression model with nomogram was used to analyze the related factors affecting colorectal precancerous lesions.Results The smoking rate in the case group was 44.0%,which was significantly higher than the smoking rate in the control group 13.7%,the difference was statistically significant(P=0.002).There was no statistically significant difference in age,gender,other demographic information,medical disease history,and alcohol drinking between the two groups.The results of the CES-D showed that among the four dimensions,the two dimensions of depression emotions and positive emotions scores,the total scores of CES-D were higher in the case group than those in the control group,the differences were statistically significant(P=0.041,0.003 and 0.003).The higher the scores of depression emotions and positive emotions in CES-D,the lower the scores of interpersonal,the higher risks of colorectal polyps[P=0.049,P=0.005 and P=0.045,with the OR values of 1.164(95%CI:1.001-1.355),1.243(95%CI:1.069-1.446)and 0.546(95%CI:0.302-0.987)].In addition to depression status,smoking is also an independent risk factor of colorectal polyps(P=0.001),with

关 键 词：抑郁 心理状况 吸烟 结直肠癌前病变 年轻患者 

分 类 号：R735.34[医药卫生—肿瘤]