系统性红斑狼疮女性患者精神障碍现况分析

目的了解系统性红斑狼疮(systemic lupus erythematosus, SLE)女性患者精神障碍现状,探究其影响因素。方法以症状自评量表(symptom check list-90, SCL-90)作为判断精神障碍的依据,疾病活动度、社会支持、贬低-歧视是可能的影响因素,采用量表进行了调查,应用多因素非条件Logistic回归模型对精神障碍的影响因素进行分析。结果女性SLE患者SCL-90总分为(136.39±48.66)分,高于常模(129.96±38.76)分(t=2.247,P=0.025),289例SLE患者经过SCL-90检出有精神障碍的人数为128例(44.3%)。高月收入(OR=0.770,95%CI:0.604～0.981,P=0.034)是精神障碍的保护因素;高疾病活动度(OR=1.792,95%CI:1.023～3.138,P=0.042)、高贬低-歧视(OR=1.100,95%CI:1.035～1.169,P=0.002)是精神障碍的危险因素。结论女性SLE患者比一般人群具有更高精神障碍的风险,消除自我贬低、减少社会歧视、积极的就业、提高月收入、进行规范治疗、降低疾病活动度可能有效减轻SLE患者的精神障碍。

Situation analysis of mental disorders in females with systemic lupus erythematosus

  Objective  To study the influences of mental disorders on female systemic lupus erythematosus(SLE)and analyze the factors.  Methods  We used symptom check list -90 (SCL-90) as a basis for judging mental disorders disease activity. Disease activity, social support and depreciation - discrimination were used as possible influencing factors. Social support and discomfort - discrimination were possible influencing factors. Multivariate unconditional logistic regression model was used to analyze the influencing factors of mental disorders.  Results  The total score of SCL-90 of patients with female SLE was significantly higher than that of norm models(136.39±48.66) vs (129.96±38.76)] (P<0.05), in 289 SLE patients, the number of patients with mental disorders was 128 (44.3%). High monthly income(OR=0.770, 95% CI: 0.604-0.981, P=0.034) was a protective factor for mental disorders. High disease activity (OR=1.792, 95% CI: 1.023-3.138, P=0.042)and high discomfort-discrimination (OR=1.100, 95% CI: 1.035-1.169, P=0.002)were risk factors for mental disorders.  Conclusions  Female SLE patients have a higher risk of mental disorders than the general population. And eliminating self-depreciation, reducing social discrimination, active employment, increasing monthly income, standardizing treatment and reducing disease activity may effectively alleviate mental disorders in SLE patients.