肝癌患者抑郁相关因素及其与生活质量的关系  

Depression-related factors and corresponding correlations with quality of life in patients with hepatocellular carcinoma

作　　者：李亚 邱世香 陈超 钟立明 Li Ya;Qiu Shixiang;Chen Chao;Zhong Liming(School of Medical Imaging,North Sichuan Medical College,Nanchong 637000,China;Institute of Brain Function Rehabilitation and Imaging,Nanchong Central Hospital,Nanchong 637000,China;Department of Interventional Radiology,Nanchong Central Hospital,Nanchong 637000,China)

机构地区：[1]川北医学院医学影像学院,四川南充637000 [2]南充市中心医院脑功能康复与成像研究所,四川南充637000 [3]南充市中心医院介入放射科,四川南充637000

出　　处：《临床荟萃》2022年第6期539-543,共5页Clinical Focus

基　　金：四川省医学科研课题计划臭氧通过Keap-Nrf2通路诱导肝癌细胞凋亡分子机制的初步研究(S19026);四川省基层卫生事业发展研究中心项目肝癌相关抑郁的高风险因素及其预测价值研究(SWFZ20-Z-008)。

摘　　要：目的探讨肝癌患者抑郁相关因素及其与患者生活质量的关系。方法纳入2019-2021年于南充市中心医院经病理确诊的肝癌患者67例,根据汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分将患者分为抑郁组和非抑郁组。比较两组临床资料差异。结果67例患者中23例患有抑郁症(34.3%),抑郁组和非抑郁组在性别、年龄、饮酒、吸烟、能否承担费用、对疾病的知情情况、治疗方法、介入治疗次数等方面差异均无统计学意义(P>0.05),在数字疼痛量表评分、匹兹堡睡眠指数(Pittsburgh sleep quality index,PSQI)评分、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评分及肝癌临床分期等方面差异均有统计学意义(P<0.05)。在生活质量评估方面,两组躯体功能、社会功能、恶心与呕吐、气促、腹泻、便秘等得分差异均无统计学意义(P>0.05),非抑郁组角色功能、情绪功能、认知功能、总体健康状况等得分均高于抑郁组(P<0.05),疲倦、失眠、疼痛、经济状况及食欲丧失等得分均低于抑郁组(P<0.05)。绘制森林图显示,PSQI评分及HAMA评分高是肝癌患者抑郁的危险因素。经多因素线性回归分析发现,是否抑郁对肝癌患者生活质量的影响差异有统计学意义(P<0.05),非抑郁患者的生活质量比抑郁患者高64.164倍。结论PSQI评分及HAMA评分高是肝癌患者抑郁的危险因素。肝癌合并抑郁患者的生活质量较差,在临床工作中需要预防肝癌患者抑郁症状的出现,以提高患者愈后及生活质量。Objective To explore the related factors of depression and corresponding correlations with quality of life in patients with hepatocellular carcinoma(HCC).Methods Sixty seven patients with HCC diagnosed by Nanchong Central Hospital by means of pathology from 2019 to 2021 were divided into the depression group and non-depression group according to scores of Hamilton Depression Scale(HAMD).The differences in clinical data of patients in two groups were compared.Results Twenty three(34.3%)out of 67 patients suffered from depression,the differences in the gender,age,marriage,education level,alcohol consumption,smoking,affordability,knowledge of disease,therapeutic method,number of interventional treatment between groups weren’t statistically significant(P>0.05),and the differences in digital pain scale score,Pittsburgh sleep quality index(PSQI)scores,HAMA scores and clinical staging of HCC were statistically significant(P<0.05).The differences in the quality of life assessment,physical function,social function,nausea&vomiting,shortness of breath,diarrhea,constipation,scores of patients in groups weren’t statistically significant(P>0.05).The scores of role function,emotional function,cognitive function,general health in the non-depression group were higher than those in the depression group(P<0.05),and the scores of fatigue,insomnia pain,and economic status and loss of appetite in the non-depression group were lower than those in the depression group(P<0.05).The plotted forest plot showed that high PSQI score and HAMA score were risk factors for depression in patients with HCC.The multivariate linear regression analysis showed that the availability of depression had statistical significance on the quality of life of patients with HCC(P<0.05),and the quality of life of non-depression patients was 64.164 times higher than that of depression patients.Conclusion High PSQI and HAMA score are considered to be risk factors for depression in patients with HCC.The patients with HCC complicated with depression have poor qual

关 键 词：肝肿瘤 抑郁 生活质量 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]