慢性乙型肝炎患者焦虑抑郁与肝功能的关系

目的探讨慢性乙型肝炎患者焦虑抑郁情绪发生与肝功能变化的关系。方法采用焦虑抑郁量表对536例慢性乙型肝炎患者和200例正常志愿者进行心理状况调查,根据调查时两周内的部分肝功能指标丙氨酸氨基转移酶（ALT）、胆红素（TBil）情况,分成肝功能正常、轻、中、重度损伤4组。肝功能异常者,在上述指标恢复正常后复测一次作为B组。用EXCEL建立数据库,采用SPSS12.0软件进行统计学分析。肝功能异常者的自身前后比较,用Wilcoxon符号秩检验,用Jonckheere-Terpstra检验进行趋势检验。结果慢性乙型肝炎患者中,焦虑症状检出率为45.3%,抑郁症状检出率为36%,与正常对照组相比,均有统计学差异。病例组中的肝功能异常组的自身前后对照P＆lt;0.001,也有统计学差异。慢性乙型肝炎患者焦虑抑郁症状检出率与肝功能损伤程度呈正相关。结论慢性乙型肝炎患者焦虑抑郁症状者显著高于正常人,慢性乙型肝炎患者肝功能损伤越重焦虑抑郁症状发生率越高。

The general mental health in patients with chronic hepatitis B and the relationship to liver function

Objective To explore the general mental health situation in patients with chronic hepatitis B and the relationship to liver function. Methods Five hundred and thirty-six patients with chronic hepatitis B and 200 volunteers were assessed by General Health Questionnaire （GHQ） and Hospital Anxiety and De- pression Scale （HADS）. Based on some liver function index （ALT and TBil） during two weeks, the patients were divided into four groups： normal liver function, liver function low-grade, middle-grade and high-grade damnified. The patients with abnormal liver function were assessed again until their liver functions were nor- mal. The database was set up using EXCEL. The statistical software used throughout the analysis was SPSS 12.0. The scale scores between baseline and the time liver function became normal were compared using Wilc- oxon signed rank test. The four groups were compared using Kruskal-Wallis test and Jonckheere-Terpstra test. Results Among patients with chronic hepatitis B, the ratio of suspicious mental disorder was 47.0%, suspi- cious heavy mental disorder was 19.4%, the detectable rate of anxious symptoms was 45.3%, and the detecta- ble rate of depressive symptoms was 36%. The differences between patient groups and normal control group were all significant. For patients with abnormal liver function, the differences between baseline and end-point were significant （ P 〈 0.001 ）. In patient groups, the ratio of perhaps with mental disorder and anxious or depressive symptoms all had positive correlation with some liver function index （ALT and TBil）. Conclusions The ratio of perhaps with mental disorder and anxious or depressive symptoms among patients with chronic hep- atitis B were higher than control. The mental health situation among patients with chronic hepatitis B related to liver function. Psychotherapy may be helpful to patients with chronic hepatitis B.