结膜松弛症患者抑郁与焦虑状态的评估  

Evaluation of depression and anxiety in patients with conjunctivochalasis

作　　者：刘江 沙咏怡 张薇[2] 孔雪晴 项敏泓[2] LIU Jiang;SHA Yongyi;ZHANG Wei;KONG Xueqing;XIANG Minhong(Department of Ophthalmology,Pudong New Area Eye Disease and Dental Disease Prevention,Shanghai201301,China;Department of Ophthalmology,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai200062,China)

机构地区：[1]上海市浦东新区眼病牙病防治所眼科,上海201301 [2]上海中医药大学附属普陀医院眼科,上海200062

出　　处：《中国医药导报》2023年第30期72-75,共4页China Medical Herald

基　　金：国家自然科学基金面上项目(82074495);上海市普陀区中心医院临床匠才计划项目(2022-RCJC-06)。

摘　　要：目的探讨结膜松弛症患者的抑郁及焦虑等情志状态的改变。方法收集2020年9月至2022年2月上海中医药大学附属普陀医院眼科确诊为结膜松弛症患者260例,采用患者健康问卷(PHQ-9)和一般焦虑症量表(GAD-7)分别评估抑郁和焦虑状态,采用眼表疾病指数(OSDI)评估眼表不适症状程度,SchirmerⅠ试验(SⅠT)、泪膜破裂时间(BUT)和角膜荧光素染色(FL)等评估患者眼表体征。结果不同临床分级患者年龄、糖尿病比例比较,差异有统计学意义(P<0.05)。不同临床分级患者PHQ-9、GAD-7评分比较,差异有统计学意义(P<0.05)。相关性分析显示,OSDI得分与PHQ-9、GAD-7评分呈正相关(r>0,P<0.05);SIT与PHQ-9、GAD-7评分呈负相关(r<0,P<0.05);BUT与PHQ-9、GAD-7评分呈负相关(r<0,P<0.05);FL得分与PHQ-9、GAD-7评分均呈正相关(r>0,P<0.05)。logistic回归分析结果显示,PHQ-9评分和GAD-7评分是结膜松弛症发生的独立危险因素(OR=1.350、1.852,P<0.05)。不同性别患者抑郁、焦虑状态比例比较,差异有统计学意义(P<0.05)。结论临床分级越高的结膜松弛症患者抑郁及焦虑程度越严重,且眼表不适症状越重,女性较男性患者更易有抑郁及焦虑情绪。在治疗结膜松弛症时应注重对患者心理状态的评估,以达到疾病的综合治疗。Objective To investigate the changes of emotional states such as depression and anxiety in patients with conjunctivochalasis.Methods A total of 260 patients diagnosed with conjunctivochalasis were collected from the Department of Ophthalmology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from September 2020 to February 2022.The depression and anxiety status were assessed by patient health questionnaire(PHQ-9)and general anxiety disorder scale(GAD-7),respectively,and the degree of ocular surface discomfort was assessed by ocular surface disease index(OSDI).SchirmerⅠtest(SIT),tear film rupture time(BUT),and corneal fluorescein staining(FL)were used to evaluate ocular surface signs.Results There were significant differences in age and proportion of diabetes among different clinical grades(P<0.05).The PHQ-9 and GAD-7 scores of patients with different clinical grades were compared,and the differences were statistically significant(P<0.05).Correlation analysis showed that OSDI score was posi-tively correlated with PHQ-9 and GAD-7 scores(r>0,P<0.05).SIT was negatively correlated with PHQ-9 and GAD-7 scores(r<0,P<0.05).BUT was negatively correlated with PHQ-9 and GAD-7 scores(r<0,P<0.05).FL scores were positively correlated with PHQ-9 and GAD-7 scores(r>0,P<0.05).Logistic regression analysis showed that PHQ-9 and GAD-7 scores were independent risk factors for conjunctival relaxation(OR=1.350,1.852,P<0.05).There was statistical significance in the proportion of depression and anxiety among different genders(P<0.05).Conclusion The higher the clinical grade,the more serious the degree of depression and anxiety,and the more severe the symptoms of ocular surface discomfort.Women are more likely to have depression and anxiety than men.In the treatment of conjunctivochalasis,we should pay attention to the evaluation of the patient’s psych-ological state,so as to achieve the comprehensive treatment of the disease.

关 键 词：结膜松弛症 抑郁 焦虑 临床分级 女性 

分 类 号：R777.3[医药卫生—眼科]