原发性急性闭角型青光眼患者心理社会因素分析及其对预后影响的初步研究

目的 分析原发性急性闭角型青光眼(acute primary angle-closure glaucoma,APACG)患者的心理健康状况及心理人格特征,探讨心理干预对APACG 治疗和预后的影响.方法 APACG确诊患者40例为病例组(A组),健康体检者20例为对照组(B组).A组入院即行控制眼压治疗,同时填写症状自评量表(symptom checklist 90,SCL-90),艾森克个性问卷(Eysenck personality questionnaire,EPQ)和生活事件量表(life event scale,LES)3种问卷.B组同样填写问卷.A1组术前、术后均给予心理干预治疗,A2组无心理干预治疗.A组患者均由同一术者予常规小梁切除术.结果 A组SCL-90量表的各项指标分值均高于B组,差异有统计学意义(P<0.05).EPQ结果显示:A组精神病性、神经质或情绪人格稳定性得分高于B组,差异有统计学意义(P<0.05).LES结果显示:在心理应激相关因素中,A组家庭事件、社交及其他事件、生活事件总分明显高于B组,差异有统计学意义(P<0.05). A1组术后眼压波动较A2组小,差异有统计学意义(P<0.05).结论 APACG患者具有精神病性、神经质倾向、情绪及人格缺少相对稳定性等心理人格特征. 心理干预对改善患者内分泌,免疫系统紊乱,维持术后平稳的安全眼压起积极作用.

Analysis of psychosocial factors in patients with acute primary angle-closure glaucoma

Objective To analyze the mental health and the psychological characteristics of patients with acute primary angle-closure glaucoma（APACG） and to explore the effects of psychological intervention on the treatment and prognosis of APACG. Methods Forty patients with APACG as case group （ group A） and 20 healthy persons as control group （group B） were concluded in the study. In group A, the intraocular pressure was controlled and three question- naires, including symptom checklist 90 （SCL-90）, Eysenek personality questionnaire （EPQ） and the life event scale （LES）, were done in each patient. In group B, the same questionnaires were done as well. Psychological intervention was performed before and after the conventional trabeculeetomy in group A1, but not in group A2. Results SCL-90 scale scores of the indicators in group A were higher than those in group B（P 〈0.05）. EPQ showed that psychotic, neu- rotic and emotional stability of personality scores in group A were higher than those in group B （P 〈 0.05 ）. LES showed that among the psychological stress-related factors the total scores of the family events, social and other events and life events in group A were significantly higher than those in group B （P 〈 0.05 ）. Fluctuation of intraocular pressure in group A1 was smaller than that in group A2 （ P 〈 0.05 ）. Conclusions Patients with APACG possesed psychotic and neurotic characteristics, as well as lack of the stability of emotion and personality psychology. Psychogical intervention might improve endocrine and immunological function of patients, and play an active role in maintaining the security of a stable postoperative intraocular pressure.