颈椎病抑郁症的相关因素分析  

An analysis on factors related to depression in cervical spondylopathy

作　　者：林海淋 陈奋勇[1] 王振宇[1] 林涛涛 莫家栋[1] 刘文革[1] LIN Hai-lin;CHEN Fen-yong;WANG Zhen-yu;LIN Tao-tao;MO Jia-dong;LIU Wen-ge(Departmant of Orthopedics,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院骨科,福建福州350001

出　　处：《中国矫形外科杂志》2021年第21期1945-1949,共5页Orthopedic Journal of China

摘　　要：[目的]探究颈椎临床和影像参数是否影响并预测颈椎病相关抑郁症。[方法]对2013年1月—2018年1月121例颈椎病的临床和影像资料进行回顾性分析。根据中国精神障碍分类与诊断标准第3版(Chinese classification and diagnostic criteria for mental disorders-3rd edition,CCMD-3)中抑郁发作诊断标准将患者分为抑郁组和非抑郁组。采用单项因素比较和二元多因素逻辑回归分析探索颈椎病抑郁症的危险因素。[结果]按CCMD-3诊断标准,33例诊断为抑郁发作,占27.27%;88例为非抑郁,占72.73%。抑郁组的年龄、颈椎前凸(cervical lordosis,CL)、C7倾斜角(C7 slope,C7S)、T1倾斜角(T1 slope,T1S)、颈倾角、颈椎曲度指数(cervical curvatare index,CCI)显著小于非抑郁组(P<0.05),抑郁组的VAS评分、NDI评分、颈倾角和PHQ-9评分显著大于非抑郁组(P<0.05),但是,两组间性别构成、BMI、是否吸烟、C0-C2 Cobb角、C2-7 SVA、胸廓入口角和颅倾角的差异均无统计学意义(P>0.05)。二元多因素逻辑回归表明:高NDI评分是抑郁的危险因素(OR=3.385,P=0.003)。[结论]颈椎病患者发生抑郁可能与临床评分的影像矢状面测量指标等多因素相关,其中高NDI评分是颈椎病抑郁症的独立危险因素。[Objective]To explore whether the clinical and radiographic parameters of the cervical spine affect and predict cervical spondylopathy-related depression.[Methods]The clinical and imaging documents of 121 patients with cervical spondylopathy were retro⁃spectively analyzed from January 2013 to January 2018.According to the Chinese classification and diagnostic criteria for mental disorders3rd edition(CCMD-3),the patients were divided into depression group and non-depressive group.Univariate comparison and binary multi⁃variate logistic regression were conducted to explore the factors related to depression in cervical spondylopathy.[Results]According to the CCMD-3 diagnostic criteria,33 patients were diagnosed as depressive episodes,accounting for 27.27%,while the remaining 88 patients were of non-depression,accounting for 72.73%.Regarding to univariate comparison,the depression group was significantly lower in terms of age,CL,C7S,T1S,cervical inclination and CCI(P<0.05),whereas significantly higher in terms of the VAS score,NDI score,NT and PHQ-9 scores than those of the non-depressed group(P<0.05),however,there were no significant differences in gender composition,BMI,smoking or not,C0-C2 Cobb angle,C2-7 SVA,TIA,and cranial inclination between the two groups(P>0.05).As result of binary multivariate logistic regression,the higher NDI score proved a risk factor for depression(OR=3.385,P=0.003).[Conclusion]The depression in cervical spondylopathy may be related to multiple factors,such as the radiographic sagittal balance and the clinical score.Among them,the high NDI score is an independent risk factor for depression in cervical spondylosis.

关 键 词：颈椎病 抑郁 中国精神障碍分类与诊断标准 颈椎矢状面参数 颈障碍指数 

分 类 号：R681.55[医药卫生—骨科学]