青光眼小梁切除术后早期滤过泡功能不良行滤过泡剥离治疗患者的焦虑、抑郁及睡眠障碍状况

目的 探讨青光眼小梁切除术后早期滤过泡功能不良行滤过泡剥离治疗患者的焦虑、抑郁及睡眠障碍状况。方法 选取行青光眼复合式小梁切除术后6个月复查恢复正常患者（A组）、早期滤过泡功能不良行滤过泡剥离治疗患者（B组）及查体健康成年人（C组）各30例,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和匹兹堡睡眠质量指数量表（PSQI）进行焦虑、抑郁及睡眠障碍评分,比较三组SAS、SDS、PSQI评分以及焦虑、抑郁及睡眠障碍阳性率差异,采用Spearman相关分析早期滤过泡功能不良行滤过泡剥离治疗患者SAS、SDS、PSQI评分的相关性。结果三组性别、年龄、文化程度、婚姻状况比较差异无统计学意义（P均>0.05）,组间均衡可比。三组SAS、SDS、PSQI评分差异有统计学意义（P均<0.05）。B组与C组比较,SAS、SDS、PSQI评分差异有统计学意义（P均<0.05）;A组与C组比较,PSQI评分差异有统计学意义（P<0.05）。分别以SAS评分≥45分、SDS评分≥50分、PSQI评分>7分作为焦虑、抑郁和睡眠障碍阳性判定标准。三组抑郁和睡眠障碍阳性率比较差异...     

消化性溃疡患者主观睡眠质量及其与心身状况相关分析

目的 探讨消化性溃疡患者的主观睡眠质量与心身状况以及二者之间的相关性.方法 采用匹茨馒睡眠质量指数馈表(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和症状自评量表(SCL-90)对60例消化性溃疡患者及60例正常对照组进行调查,并通过相关分析探讨消化性溃疡患者主观睡眠质量和心身状况之间的关系.结果 患者组与对照组在各项量表分的差异均有统计学意义(P＜0.05).消化性溃疡患者的PSQI与SAS、SDS、SCL-90之间呈正相关关系(P＜0.05).结论 消化性溃疡患者主观睡眠质量较差,并存在与精神症状相关的睡眠障碍.     

睡眠障碍对老年慢性功能性便秘患者焦虑抑郁情绪和生活质量的影响分析

背景随着饮食结构的改变和生活方式的快速变化,慢性便秘发病率呈逐渐上升趋势.睡眠障碍可增加胃肠道症状,也是焦虑、抑郁形成的一个危险因素.本研究旨在探讨睡眠障碍对老年慢性功能性便秘患者焦虑抑郁情绪和生活质量的影响进行分析,以期为治疗老年慢性功能性便秘患者的新思路提供客观依据.目的旨在探讨睡眠障碍对老年慢性功能性便秘患者焦虑抑郁情绪和生活质量的影响分析.方法选择2017-03/2019-09在我院就诊的126例老年慢性功能性便秘患者为研究对象,根据是否有睡眠障碍分为睡眠障碍组和睡眠正常组.对所有患者进行便秘评分系统(constipatipation scoring system, CSS)、便秘患者症状自评问卷(patient assessment of constipation symptom,PAS-SYM)、睡眠质量评估、焦虑自评量表(self-rating anxiety scale, SAS)、抑郁自评量表(selfrating depression scale, SDS)及生活质量量表评分.结果睡眠障碍组CSS评分为19.63分±3.36分, PAS-SYM评分为1.59分±0.52分,SAS评分为58.92分±6.72分, SDS评分为57.74分±6.38分,均高于睡眠正常组(P 0.05).睡眠障碍组患者社会功能评分为71.56分±3.38分、情绪评分为75.89分±2.95分、躯体角色评分为76.86分±2.92分、躯体健康评分为80.25分±3.35分、心理卫生评分为78.36分±3.65分、总健康评分为76.19分±2.56分,均低于睡眠正常组,差异有统计学意义(P0.05). CSS、PAC-SYM各维度评分以及总分均与SAS、SDS评分呈正相关(P0.05);生活质量量表中6个维度的得分与SAS、SDS评分均呈负相关(P0.05).结论睡眠障碍和焦虑、抑郁可能是影响老年慢性功能性便秘患者临床症状的重要因素,并影响患者生活质量.     

肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

基于“脑-肠轴”理论探讨老年慢性便秘患者睡眠障碍与焦虑抑郁和生活质量相关性

背景睡眠障碍可增加胃肠道症状发生率,而且长期睡眠质量的下降也是焦虑、抑郁形成的一个危险因素.本研究基于"脑-肠轴"理论探讨睡眠障碍是否加重老年慢性便秘患者的临床表现,是否影响患者心理情绪和生活质量.目的基于"脑-肠轴"理论探讨老年慢性便秘患者睡眠障碍与焦虑抑郁和生活质量相关性.方法选择2017-03/2019-09在我院住院治疗的126例老年慢性便秘患者为研究对象,对所有患者便秘评分系统,便秘患者症状自评问卷,睡眠质量评估,焦虑、抑郁量表及生活质量量表评分.结果睡眠障碍组便秘评分系统(constipatipation scoring system,CSS)评分为19.63分±3.36分,便秘患者症状自评问卷(patient assessment of constipation symptom,PAS-SYM)为1.59分±0.52分,焦虑自评量表(self-rating anxiety scale,SAS)评分为58.92分±6.72分,抑郁自评量表(self-rating depression scale, SDS)评分为57.74分±6.38分,均高于睡眠正常组(P <0.05).睡眠障碍组患者社会功能评分为71.56分±3.38分、情绪评分为75.89分±2.95分、躯体角色评分为76.86分±2.92分、躯体健康评分为80.25分±3.35分、心理卫生评分为78.36分±3.65分、总健康评分为76.19分±2.56分,均低于睡眠正常组,差异有统计学意义(P <0.05).CSS,PAC-SYM各维度评分以及总分均与SAS、SDS评分呈正相关(P <0.05);SF-36中6个维度的得分与SAS、SDS评分均呈负相关(P<0.05).结论脑-肠轴是沟通胃肠道与脑之间的桥梁,睡眠障碍和焦虑、抑郁可能是影响老年慢性便秘患者临床症状的重要因素,并影响患者生活质量.     

194例行胃镜检查老年患者焦虑和抑郁问卷分析

目的 评估接受电子胃镜检查的老年患者的焦虑、抑郁情况.方法 从2010年4月至6月我们采用SAS(焦虑)和SDS(抑郁)自评量表对在本院接受过电子胃镜检查的患者进行自评调查.结果 194例60岁以上接受电子胃镜检查的患者中,女性患者中焦虑、抑郁患者所占比例明显高于男性患者(P＜0.05)；有焦虑及抑郁的患者其在做胃镜检...     

心理干预对围绝经期妇女睡眠质量和心理健康的影响

目的探讨心理干预对围绝经期妇女睡眠质量和心理健康的作用。方法围绝经期妇女220例采用随机数字表法分为对照组110例,实施常规指导和观察组110例,实施心理干预;护理前后进行焦虑量表(SAS)、抑郁量表(SDS)、匹兹堡睡眠质量指数量表(PSQI)、症状自评量表(SCL-90)评定,比较两组干预效果。结果护理后,两组SAS、SDS、PSQI评分(睡眠质量、时间、潜伏期、睡眠障碍、睡眠效率、药物使用、日间功能、总分)、SCL-90评分(躯体化、焦虑、抑郁、强迫症状、敌对、恐惧、人际关系敏感、偏执、精神病性)降低(P0.05)。观察组上述SAS、SDS、PSQI评分、SCL-90评分低于对照组(P0.05)。结论心理干预可明显改善围绝经期妇女的睡眠质量和心理健康状况,疗效显著。     

抗焦虑抑郁治疗对“双心”疾病患者抗血小板出血风险的意义

目的:探讨抗焦虑抑郁治疗能否减少冠心病伴焦虑抑郁患者常规抗血小板治疗后出血事件发生率。方法:选择冠心病伴焦虑抑郁患者134例,随机分为A组(常规抗血小板,63例)和B组(常规抗血小板+抗焦虑抑郁,71例),分别观察两组3个月和12个月的出血情况。结果:3个月A组出血发生率28.57%(18/63),SAS(SDS)量表平均得分(68.23±11.45);B组出血发生率9.86%(7/71),SAS(SDS)量表平均得分(61.17±10.64);均差异有统计学意义(均P<0.05)。12个月A组出血发生率33.33%(21/63)例,SAS(SDS)量表平均得分(70.01±8.28);B组出血发生率12.68%(9/71),SAS(SDS)量表平均得分(56.98±9.76);均差异有统计学意义(均P<0.05)。结论:抗焦虑抑郁治疗能显著减少冠心病伴焦虑抑郁患者常规抗血小板的出血事件发生率。     

放松疗法联合高压电位治疗脑卒中后睡眠障碍的临床疗效

目的分析放松疗法和高压电位治疗对脑卒中后睡眠障碍的治疗效果。方法选取60例脑卒中后睡眠障碍住院患者,随机分为三组,每组20例。对照组予以常规康复治疗;高压电位治疗组予以常规康复治疗加高压电位治疗;联合治疗组予以常规康复治疗加放松疗法联合高压电位治疗。各组患者常规的康复治疗方法相同。治疗前后各组行抑郁自评量表(SDS)、焦虑自评量表(SAS)、匹兹堡睡眠质量指数(PSQI)评定。结果对照组治疗前后3项评分均无明显差异(P0.05);高压电位治疗组治疗前后PSQI、SAS评分有明显差异(P0.05),但SDS评分无统计学差异(P0.1);联合治疗组治疗前后3项评分均有显著差异(P0.05)。治疗后高压电位治疗组和联合治疗组SDS、SAS、PSQI评分与对照组有明显差异(P0.05);联合治疗组SDS、SAS、PSQI评分较高压电位治疗组有明显差异(P0.05)。结论高压电位治疗可以改善脑卒中后患者的睡眠障碍,放松疗法联合高压电位治疗对脑卒中后患者的睡眠障碍有明显疗效。     

某三级医院老年功能性消化不良患者睡眠质量与焦虑抑郁相关性研究

背景功能性消化不良(functional dyspepsia,FD)是影响老年患者睡眠质量的常见疾病之一,长期睡眠障碍患者伴有不同程度的焦虑,抑郁情绪.目的观察某三级医院老年FD患者睡眠质量与焦虑抑郁情绪的优势分析,并探讨睡眠质量各因子在预测焦虑、抑郁情绪中的重要性.方法选择2017-09/2019-09在浙江省金华市第二医院住院的老年FD患者112例为研究对象,采用匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)和焦虑/抑郁自评量表(anxiety/depression self-rating scale,SAS/SDS)进行调查,运用优势回归方法对其关系进行深入分析.结果老年FD患者在睡眠质量、入睡时间、睡眠效率、催眠药物、PSQI及SAS总分方面女性评分均低于男性(P<0.05),而各维度总评分明显高于国内常模(P<0.05).通过回归分析发现,在性别和睡眠质量因子中的日间功能、睡眠质量、睡眠时间及睡眠效率对焦虑情绪的预测水平较高(P<0.05).睡眠质量因子中的睡眠效率和日间功能对抑郁情绪的预测水平较高(P<0.05).回归分析提示变量X1在已预测方差中为61.54%,X2在已预测方差中为38.46%.睡眠质量与焦虑、抑郁情绪分层及逐步回归后,4个变量(X1,X2,X3,X4)进入回归方程,最终X1在已预测方差中为38.26%,X2为22.86%,X3为17.63%,X4为20.85%.结论睡眠质量各因子中日间功能,睡眠质量,睡眠效率,睡眠时间对焦虑情绪有预测作用,而睡眠效率、日间功能对抑郁情绪有预测作用,因此在临床工作应根据睡眠质量各因子采取针对性的治疗和护理干预.     

心理因素与腹泻型肠易激综合征关系的研究

背景:近年来肠易激综合征(IBS)的发病率有逐渐上升的趋势,但其病因和发病机制尚不清楚。目的:研究心理因素在腹泻型IBS发病中的地位和作用。方法:分别统计腹泻型IBS患者、病程类似的慢性胃炎患者和正常对照者(各50例)的Zung’s抑郁自评量表(SDS)和焦虑自评量表(SAS)评分,分析腹泻型IBS患者的病程与SDS、SAS评分的相关性。结果:腹泻型IBS患者与慢性胃炎患者的SDS、SAS评分无显著差异(P>0.05),但均显著高于正常对照组(P<0.001)。腹泻型IBS患者的病程与SDS、SAS评分有显著相关性(P<0.001)。结论:腹泻型IBS患者表现出的抑郁、焦虑等心理障碍可能是IBS的结果,而不是其原因;IBS的真实原因尚有待进一步研究。     

品管圈活动对老年肿瘤化疗患者焦虑、抑郁、睡眠质量和心理健康的干预效果观察

目的观察品管圈活动对老年肿瘤化疗患者焦虑、抑郁、睡眠质量和心理健康的干预效果,为改善患者的负性精神状况提供方法。方法选取2019年7月~2020年1月于复旦大学附属华东医院日间化疗病房接受化疗的肿瘤患者120例,根据数字表法随机分为试验组(n=60)和对照组(n=60)。对照组患者接受常规护理干预,试验组患者在与对照组相同常规护理基础上,增加品管圈活动干预。分别采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹玆堡睡眠质量指数量表(PSQI)和症状自评量表(SCL-90),对2组干预前后的焦虑、抑郁、睡眠质量和心理健康程度进行评分和比较。结果干预前,2组的SAS评分、SDS评分、PSQI各项因子评分和SCL-90各项指标评分差异均无统计学意义(P>0.05);干预后,2组的SDS评分、SDS评分、PSQI各项因子评分和SCL-90各项指标评分均明显低于同组干预前(P<0.05),且试验组均显著低于对照组(P<0.05)。结论品管圈活动可明显改善老年化疗患者的焦虑和抑郁程度、睡眠质量和心理健康,具有一定的临床应用价值。     

Prevalence of psychological disorders,sleep disturbance and stressful life events and their relationships with disease parameters in Chinese patients with ankylosing spondylitis

Our aim was to investigate the prevalence of psychological disorders, sleep disturbance, and stressful life events in Chinese patients with ankylosing spondylitis (AS) and healthy controls, to assess the correlation between psychological and disease-related variables, and finally to detect powerful factors in predicting anxiety and depression. AS patients diagnosed with the modified New York criteria and healthy controls were enrolled from China. Participants completed a set of questionnaires, including demographic and disease parameters, Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), the Pittsburgh Sleep Quality Index questionnaire (PSQI), and the Social Readjustment Rating Scale (SRRS). The relationship between psychological and other variables was explored. Stepwise multiple regression was used to determine the contributors to each disorder. Of all the 2772 AS patients, 79.1% were male. Mean age was 28.99 ± 8.87 years. Prevalence of anxiety, depression, and sleep disturbance was 31.6% (95% CI, 29.9, to 33.4), 59.3% (95% CI, 57.5, to 61.2), and 31.0% (95% CI, 29.3, to 36.7), respectively. 35.3% had stimulus of psychological and social elements (SPSE). Compared with healthy controls, AS patients had more severe psychological disorders, sleep disturbance, and stressful life events (P < 0.01). SDS, overall pain, BASFI, and sleep disturbance were significant contributors of the SAS scores (P < 0.03). SAS, less years of education, and sleep duration were significant contributors of SDS (P < 0.01). AS patients had more anxiety, depression, stressful life events, and sleep disturbance than healthy controls. Pain, functional limitation, sleep disturbance, and education were major contributors to psychological disorders.     

心理干预对膝骨关节炎患者临床疗效的研究

目的 探讨心理干预对膝骨关节炎患者临床疗效的作用.方法 采用随机对照研究试验方法,对92例膝骨关节炎患者进行为期1个月的观察,47例物理治疗合并心理干预,45例物理治疗为对照组.测查一般资料、生理指标、健康状况调查问卷(SF-36)、抑郁自评量表(SDS)和焦虑自评量表(SAS)并作干预前后比较分析.统计学方法采用t检验,方差分析.结果 ①膝骨关节炎患者治疗前后生理指标变化的差异均无统计学意义(P＞0.05);②SDS分有随治疗时间逐渐下降的趋势,SDS总分心理干预组较无心理干预组下降明显(P＜0.05).③SAS分有随治疗时间逐渐下降的趋势,2组SAS分下降程度差异无统计学意义(P＞0.05).④治疗前后心理干预组在生理机能、躯体疼痛、精力、情感职能4个纬度较无心理干预组改善明显.⑤SDS与生理机能、躯体疼痛、一般健康状况、精力、社会功能负相关(r=-0.739～-0.521,P＜0.05);SAS与精力、社会功能呈负相关(r=-0.699～-0.475,P＜0.05).结论 心理干预可以缓解膝骨关节炎患者抑郁情绪,改善膝骨关节炎患者生存质量.     

焦虑、抑郁及睡眠障碍与胃食管反流病的相关研究

ObjectiveTo analyze the mental abnormalities in patients with gastroesophageal reflux disease (GERD), and to explore the correlation between GERD and mental disorders. MethodsA total of 40 patients who diagnosed in our hospital from December 2017 to June 2018 were selected, then further divided into non erosive reflux disease (NERD) group and refluxive esophagitis (RE) group according to clinical manifestations, GERD questionnaire score and gastrointestinal endoscopy. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Pittsburgh sleep quality index (PSQI) were used in two groups. ResultsAccording to the analysis result of HAMA in the two groups, the anxiety scale of NERD group was significantly higher than that of RE group (P＜0.05);HAMD analysis shows that depression scale in NERD group was significantly higher that RE group (P＜0.05); PSQI analysis shows that sleep disorder scale in NERD group was significantly higher that RE group (P＜0.05); the correlation analysis of GerdQ score showed that anxiety, depression and sleep disorder were positively correlated with the severity of symptoms (P＜0.05). ConclusionThe depression, anxiety and sleep disorder in NERD patients is higher than that in RE group. The scale of anxiety, depression and sleep disorder is helpful to the psychological intervention and the choice of rational drug treatment in GERD patients with mental disorders.     

老年综合评估干预对良性前列腺增生患者抑郁和焦虑情绪的影响

目的 探讨老年综合评估(CGA)干预对良性前列腺增生症(BPH)患者抑郁、焦虑情绪的影响.方法 2009年6月至2010年6月我院老年科门诊90例BPH患者(≥65岁)随机分成对照组(45例)及CGA干预组(45例),对照组采用常规治疗及对症处理,干预组首先采用CGA,在此基础上拟定综合治疗方案,指导会诊,并给予治疗及对症处理.治疗前及随访6个月后门诊进行国际前列腺症状评分( IPSS)、生活质量评分(QOLS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评估,并分别进行两组治疗前后对比分析,以评价CGA对BPH患者生活质量及抑郁、焦虑情绪的影响.结果 对照组治疗后BPH患者的IPSS、QOLS、SDS和SAS评分均明显减少(t=11.0,5.84,7.08和9.68,均P＜0.01),CGA干预组治疗后BPH患者的IPSS、QOLS、SDS和SAS评分均明显减少(t=14.0,10.4,9.16和6.1,均P＜0,01).随访6个月后CGA干预组BPH患者的IPSS、QOLS、SDS和SAS评分明显低于同期对照组(t=4.25,5.55,3.45和2.88,P＜0.01).结论 老年综合评估可以明显改善良性前列腺增生患者的生活质量及抑郁、焦虑情绪.     

核苷(酸)类似物抗病毒治疗对慢性乙型肝炎患者焦虑和抑郁状态的影响

目的 探讨核苷(酸)类似物抗病毒治疗对慢性乙型肝炎患者的焦虑和抑郁状态的影响,并分析其影响因素.方法 用中文版焦虑自评量表(SAS)和抑郁自评量表(SDS)测量核苷(酸)类似物抗病毒治疗的120例慢性乙型肝炎患者治疗前、治疗1年和治疗2年时的焦虑和抑郁状态.记录患者的人口学资料,并定期检测患者的ALT和HBV DNA等指标.计数资料采用x2检验,计量资料采用t检验、单因素方差分析,多因素Logistic回归分析.结果 慢性乙型肝炎患者抗病毒治疗前、治疗1年、治疗2年的SAS、SDS平均得分随抗病毒治疗时间的延长而降低(F=12.661、22.395,均P＜0.01).治疗前、治疗1年、治疗2年时SAS、SDS得分大于50分的患者分别为5.8％、4.2％、1.7％和13.3％、7.5％、5.0％.治疗2年时,HBV DNA转阴和未转阴的患者,焦虑改善率分别为69.0％、22.2％(x2 =22.325,P＜0.01);抑郁改善率分别为77.4％、22.2％(x2＝32.179,P＜0.01).多因素Logistic回归分析显示,与HBV DNA未阴转的患者相比,阴转的患者焦虑、抑郁改善的比值比(OR)及其95％可信区间(CI)分别为7.751 (3.026～19.853)、15.069(5.309～42.770);与ALT未复常的患者相比,ALT复常的患者抑郁改善的OR值及其95％CI为4.103(1.376～12.238).结论 核苷(酸)类似物抗病毒治疗能改善慢性乙型肝炎患者的焦虑和抑郁状态.HBV DNA阴转是焦虑和抑郁改善的独立影响因素.     

肠易激综合征患者情绪障碍调查及其发生机制研究

目的研究肠易激综合征(IBS)患者抑郁、焦虑发生情况及其发生的病理生理机制。方法对50例IBS患者和50例正常对照者进行抑郁自评(SDS)、焦虑自评(SAS)及艾森克个性问卷(EPQ);并将抑郁、焦虑评分与局部脑血流灌注量进行相关分析。结果 IBS患者抑郁发生率为76%,以中度抑郁为主;焦虑发生率为46%,以轻度焦虑为主;对照组无抑郁发生,轻度焦虑10.6%。抑郁评分与左侧屏状核,左侧豆状核、右侧直回、右侧钩回血流灌注呈负相关,与左侧楔叶、两侧楔前叶、左侧枕上回、右侧缘上回、右侧顶下小叶血流呈正相关。焦虑评分与左侧屏状核、左侧岛叶血流呈负相关。结论 IBS患者存在明显抑郁、焦虑情绪;大脑血流灌注异常可能是其发生情绪障碍的病理生理机制之一。