不同年龄原发性开角型青光眼患者手术前后心理特征和生存质量的变化

目的探讨不同年龄原发性开角型青光眼(POAG)患者手术前后心理特征及生存质量变化的差别。方法纳入POAG患者76例,其中青年患者38例、中老年患者38例。所有POAG患者术前采用家庭支持量表、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及低视力者生活质量量表(LVQOL)进行测试;术后3 d采用HAMA、HAMD进行测试,术后1个月采用HAMA、HAMD、LVQOL进行测试。结果术后1个月,青年组HAMA总分A、HAMD总分B与术后3 d差异无统计学意义(PA=0.585,PB=0.313);而中老年组HAMA总分A、HAMD总分B较术后3 d下降(PA=0.012,PB=0.014)。术后1个月,LVQOL总分较术前升高,差异有统计学意义(P=0.007);青年患者LVQOL总分与术前差异无统计学意义(P=0.238)。多元逐步回归分析显示,术后1个月LVQOL总分的主要影响因素是较好眼视野MD(β=0.410,P=0.002)、健康教育(β=10.134,P<0.01)、术后1个月HAMD总分B(β=-0.795,P<0.01)。结论心理特征及生存质量在青年及中老年POAG患者手术治疗前后发生不同变化,尤其对于青年POAG患者应加强必要的心理支持。

Changes in psychological characteristics and quality of life of patients with primary open-angle glaucoma before and after surgery at different ages

Objective To explore the differences in psychological characteristics and quality of life(QOL)of patients with primary open-angle glaucoma(POAG)at different ages before and after surgery.Methods Seventy-six POAG patients were enrolled,including 38 youth patients and 38 elderly ones.All patients were tested with Family Support Scale,Hamilton Anxiety Scale(HAMA)and Hamilton Depression Sale(HAMD)and Low Vision Quality of Life Scale(LVQOL)before surgery.The HAMA and HAMD were used for testing 3 days after the operation.The HAMA,the HAMD,and LVQOL were tested 1 month after the operation.Results At 1 month after operation,the total score of HAMA and HAMD showed no significant difference in the youth group,comparing with that at the 3 days after the operation(PA=0.585,PB=0.313);The total score of HAMA and HAMD in the elderly group were significantly lower than those at the 3 days after the operation(PA=0.012,PB=0.014);At one month after operation,the elderly group had higher score in the sum of LVQOL than that in preoperative time(P=0.007);The youth group had similar score in the sum of LVQOL comparing with that in preoperative time(P=0.238).The results of multiple stepwise regression indicated that mean deviation in the better eye(β=0.410,P=0.002),health education(β=10.134,P<0.01),and he total score of HAMD(β=-0.795,P<0.01)are the main factors influencing QOL at one month after operation.Conclusions Psychological characteristics and quality of life will vary between young and middle-aged and elderly POAG patients before and after surgery.Especially for young POAG patients,necessary psychological support should be strengthened.