透析患者躯体化症状与抑郁焦虑睡眠障碍心身疾病诊断及实验室指标的相关性分析  

Correlation of somatization symptoms with the diagnosis of depression,anxiety,sleep disorders,psychosomatic disease as well as laboratory indicators in dialysis patients

作　　者：胡汇悦 吴爱华 沐晓蝶 周华[1] 凌佩瑶[1] Hu Huiyue;Wu Aihua;Mu Xiaodie;Zhou Hua;Ling Peiyao(The Third Affiliat ed Hospital of Soochow University,Changzhou 213003,Jiangsu,China)

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院),江苏常州213003

出　　处：《临床心身疾病杂志》2024年第4期16-21,共6页Journal of Clinical Psychosomatic Diseases

基　　金：国家自然科学基金项目(编号82000684);常州市“十四五”卫生健康高层次人才培养工程(编号2022260)。

摘　　要：目的 研究透析患者躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病及实验室指标的关系。方法 收集132例透析患者的一般临床资料和实验室指标数据,采用匹兹堡睡眠质量指数量表(PSQI)、广泛性焦虑障碍-7量表(GAD-7)、患者健康问卷-9抑郁量表(PHQ-9)、健康问卷躯体症状群量表(PHQ-15)、心身研究的诊断标准(DCPR)评估患者的睡眠、焦虑、抑郁、躯体化症状、心身状态。根据PHQ-15评分将入组患者分为观察组63例(有躯体化症状)和对照组69例(无躯体化症状)。比较两组患者一般资料、实验室指标数据和各项量表评分;采用Pearson、Spearman相关分析研究躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病以及各项实验室指标的相关性。结果 两组患者白细胞计数、中性粒细胞计数及血红蛋白、白蛋白水平比较,差异均有统计学意义(P<0.05或0.01)。观察组患者PSQI、PHQ-9、GAD-7评分均高于对照组,综合征诊断个数多于对照组(P<0.01)。Pearson相关分析显示,透析患者PHQ-15评分与中性粒细胞计数呈正相关(P<0.05),与白蛋白呈负相关(P<0.05)。Spearman偏相关分析显示,控制PHQ-9评分、GAD-7评分和综合征诊断个数后,PHQ-15评分与PSQI评分呈正相关(P<0.01);控制PHQ-9评分、PSQI评分和综合征诊断个数后,PHQ-15评分与GAD-7评分呈正相关(P<0.01);控制GAD-7评分、PSQI评分和综合征诊断个数后,PHQ-15评分与PHQ-9评分呈正相关(P<0.01);控制GAD-7评分、PSQI评分和PHQ-9评分后,PHQ-15评分与综合征诊断个数呈正相关(P<0.05)。结论 透析患者躯体化症状与睡眠障碍、焦虑、抑郁、心身疾病诊断情况及患者的中性粒细胞计数、白蛋白水平密切相关。Objective To study the cor relation of somatization symptoms with the sleep disorders,a n xiet y,depression,psychosomatic disease as well as laboratory indicators in dialysis patients.Methods Clinical and laboratory index data of 132 dialysis patients were collected,patients'sleep,anxiety,depression,somatization symptoms and psychosomatic states assessed using the Pittsburgh Sleep Quality Index(PSQI),Generalized Anxiety Disorder Questionnaire-7(GAD-7),Patient Health Questionnai re-9(PHQ-9),Patient Health Questionnai re-15(PHQ-15)and Diagnostic Criteria for Psychosomatic Research(DCPR),respectively.The patients were divided into observation(with somatization symptoms,n=63)and control(without somatization symptoms,n=69)according to PHQ-15 score s.Genera l dat a,laboratory indexes and al l sca les score were compa red between two groups.Pea r son and Spearman correlation analysis were used to study the correlation of somatization symptoms with sleep disorders,anxiety,depression,and psychosomatic disease as well as various laboratory indicators.Results Intergroup differences in leukocytes and neutrophil count,hemoglobin and albumin levels were statistically significant(P<0.05 or 0.01).The PSQI,PHQ-9 and GAD-7 score were all higher and the number of diagnosed syndromes was more in observation than control group,differences were statistically significant(P<0.01).Pearson cor relation analysis showed that the PHQ-15 score of dialysis patient was positively cor related with neut rophil count(P<0.05)and negatively with albumin level(P<0.05).Spearman par tial cor relation analysis showed that af ter cont rolling for PHQ-9 and GAD-7 score as well as the number of diagnosed syndromes the PHQ-15 score was positively cor related with the PSQI score(P<0.01),after controlling for PHQ-9 and PSQI score as wel l as the number of diagnosed syndromes the PHQ-15 score posit ively with GAD-7 score(P<0.01),after controlling for GAD-7 and PSQI score as well as the number of diagnosed syndromes the PHQ-15 score positively with the PHQ-9 sc

关 键 词：透析 躯体化症状 睡眠障碍 抑郁 焦虑 心身疾病 白蛋白 中性粒细胞计数 

分 类 号：R459.5[医药卫生—治疗学] R395[医药卫生—临床医学]