幽门螺杆菌感染对慢性胃炎患者焦虑、抑郁的影响  

Influence of Helicobacter pylori infection on anxiety and depression in patients with chronic gastritis

作　　者：陈雨欣 赵新 陈星星 毕含鑫 张路遥 张丽峰 时永全 Chen Yuxin;Zhao Xin;Chen Xingxing;Bi Hanxin;Zhang Luyao;Zhang Lifeng;Shi Yongquan(Graduate Department of Xi′an Medical University,Xi′an 710021,China;Department of Gastroenterology,First Hospital Affiliated to Air Force Medical University,State Key Laboratory of Tumor Biology,National Clinical Research Center for Digestive Diseases,Xi′an 710032,China)

机构地区：[1]西安医学院研究生处,西安710021 [2]空军军医大学第一附属医院消化内科、肿瘤生物学国家重点实验室、消化系疾病国家临床医学研究中心,西安710032

出　　处：《中华消化杂志》2023年第1期18-23,共6页Chinese Journal of Digestion

基　　金：国家自然科学基金(82170560);陕西省重点研发计划(2023-ZDLSF-35)。

摘　　要：目的评估幽门螺杆菌(H.pylori)感染对慢性胃炎患者焦虑、抑郁的影响。方法连续纳入2020年12月1日至2021年6月30日就诊于空军军医大学第一附属医院消化内科门诊的慢性胃炎患者387例,根据现症H.pylori感染状态分为H.pylori未感染组和H.pylori感染组。收集患者基本人口学信息并填写汉密尔顿焦虑量表、汉密尔顿抑郁量表24项版、匹兹堡睡眠质量指数(PSQI)和胃肠道症状分级评分量表(GSRS)。比较不同人口学特征的H.pylori未感染组与H.pylori感染组的焦虑、抑郁检出率。统计学方法采用卡方检验和多元logistic回归分析。结果最终纳入360例慢性胃炎患者,其中H.pylori未感染组200例,H.pylori感染组160例。H.pylori感染组焦虑、抑郁检出率均高于H.pylori未感染组[48.1%(77/160)比30.0%(60/200)、25.0%(40/160)比12.5%(25/200)],差异均有统计学意义(χ^(2)=12.39、9.39,P<0.001、=0.002)。H.pylori感染组男性患者焦虑检出率高于H.pylori未感染组[45.1%(32/71)比24.5%(27/110)];H.pylori感染组女性患者抑郁检出率高于H.pylori未感染组[30.3%(27/89)比11.1%(10/90)],差异均有统计学意义(χ^(2)=8.27、10.09,P=0.004、0.001)。H.pylori感染组年龄<48岁患者焦虑、抑郁检出率均高于H.pylori未感染组[46.2%(37/80)比21.9%(21/96)、20.0%(16/80)比7.3%(7/96)],差异均有统计学意义(χ^(2)=11.73、6.20,P=0.001、0.013)。H.pylori感染组高中及以下文化程度患者H.pylori感染组焦虑、抑郁检出率均高于H.pylori未感染组[56.5%(48/85)比31.7%(38/120)、32.9%(28/85)比14.2%(17/120)],差异均有统计学意义(χ^(2)=12.57、10.24,P<0.001、=0.001)。多因素分析显示,H.pylori感染、高血压病史、PSQI评分≥8分、GSRS评分≥7分、慢性浅表性胃炎和慢性萎缩性胃炎均为慢性胃炎患者发生焦虑的独立危险因素(P<0.001、=0.013、=0.001、<0.001、=0.036、=0.021),其中H.pylori感染者发生焦虑的风险是未感染者的2.509倍(95%置信区间1.512~4.1Objective To evaluate the influence of Helicobacter pylori(H.pylori)infection on anxiety and depression in patients with chronic gastritis.Methods From December 12020 to June 302021,387 patients with chronic gastritis who visited the outpatient Department of Gastroenterology,the First Hospital Affiliated to Air Force Medical University were continuously recruited.According to the status of current H.pylori infection,the patients were divided into H.pylori uninfected group and H.pylori infected group.The general demographic information of patients was collected.Hamilton anxiety scale,Hamilton depression rating scale-24,Pittsburgh sleep quality index(PSQI)and gastrointestinal symptom rating scale(GSRS)were filled in.The detection rates of anxiety and depression were compared between the H.pylori uninfected group and the H.pylori infected group according to demographic characteristics.Chi-square test and multiple logistic regression analysis were used for statistical analysis.Results Finally,360 patients with chronic gastritis were enrolled,including 200 patients in H.pylori uninfected group and 160 patients in H.pylori infected group.The detection rates of anxiety and depression of the H.pylori infected group were both higher than those of the H.pylori uninfected group(48.1%,77/160 vs.30.0%,60/200;25.0%,40/160 vs.12.5%,25/200),and the differences were statistically significant(χ^(2)=12.39 and 9.39,P<0.001 and=0.002).The detection rate of anxiety of male patients in the H.pylori infected group was higher than that in the H.pylori uninfected group(45.1%,32/71 vs.24.5%,27/110);the detection rate of depression of female patients in the H.pylori infected group was higher than that in the H.pylori uninfected group(30.3%,27/89 vs.11.1%,10/90),and the differences were statistically significant(χ^(2)=8.27 and 10.09,P=0.004 and 0.001).The detection rates of anxiety and depression of patients less than 48 years old in the H.pylori infected group were both higher than those in the H.pylori uninfected group(46.2%,37/80 vs.21.

关 键 词：慢性胃炎 幽门螺杆菌 焦虑状态 抑郁状态 

分 类 号：R573.3[医药卫生—消化系统] R749[医药卫生—内科学]