酒精使用障碍患者在医院就诊现状的非干预性横断面调查

发布时间：2018-07-05 06:35

本文选题：酒精使用障碍 + 酒精依赖　；参考：《中南大学》2014年硕士论文

【摘要】：目的 1.调查某个时间段内消化科门诊和住院部,研究人群(AUDIT≥7分)中可能患有酒精依赖的患者(女性AUDIT≥13分,男性AUDIT≥15分)所占的比例。 2.了解研究人群(AUDIT≥7分)的人口学特点、饮酒模式及心理状态。 3.通过SF-36量表描述研究人群(定义为AUDIT≥7分)的生命质量,BDI量表评估研究对象的心理状况。 4.比较研究人群中7分≤AUDIT13或15分人群和可能有酒精依赖人群(女性AUDIT≥13分,男性AUDIT≥15分)之间人口学特征、心理情况及生活质量之间的差异。 5.了解酒精使用障碍程度的影响因素和危险因素。方法本研究为非干预性横断面调查,调查将收集因躯体疾病而到湘雅二医院消化科门诊或病房寻求医疗帮助的患者基线信息。无论其躯体疾病是否与饮酒相关均使用AUDIT量表筛选患者,满足入组条件者收集其饮酒频率、模式、饮酒行为等饮酒相关信息,并使用SF-36量表收集其生命质量各维度情况及用Beck抑郁自评量表进行自我评估。将入组研究对象按危险饮酒(定义为：女性患者7分≤AUDIT评分13分；男性患者7分≤AUDIT评分15分)和可能患有酒依赖的患者(定义为：女性患者AUDIT评分≥13分；男性患者AUDIT评分≥15分)分为两组,分别比较两组之间人口学资料、生命质量及抑郁程度等指标的差异。该研究仅进行一次访视,通过研究者评定和患者自评的问卷和量表收集临床信息。将问卷和量表进行数据收集,建立数据库并进行统计分析。结果 1.我院消化科可能患酒精使用障碍(男性AUDIT评分≥15分、女性AUDIT评分≥13分)比例门诊为5.95%,病房为3.05%,与全国性调查发现酒精依赖患病率1993年为3.4%,2003年为3.8%相比,门诊高于全国性酒精依赖患病率,而病房略低于全国性；而危险饮酒(7分≤AUDIT评分≤13/15分)门诊和病房的比例分别为3.81%和0.78%。 2.入组的149例研究对象经过统计,其中有47%最常饮高度白酒(52°及以上),余下依次为啤酒26.2%、米酒/谷酒15.4%；7分AUDIT13/15分人群最常饮酒类型为啤酒,其比例为50%,高度白酒和米酒/谷酒次之,比例分别为25%和14.6%；而AUDIT≥13/15分人群最常饮酒为高度白酒,其比例为57.4%,米酒/谷酒和啤酒次之,分别为15.8%和14.9%。提示在不同程度的酒精使用人群中,最常饮酒类型不一致。 3.入组研究人群的平均每周饮酒次数为8.31士6.19次/周,最多可达30次；平均每次饮酒量在3-5个标准杯之间；四周饮酒天数主要集中在10天和28天。提示在入组人群中按照饮酒天数分组明显分为两组组,且两组之间在饮酒程度、饮酒次数和在酒精依赖的程度上各具特点。 4. AUDIT评分高组(男性AUDIT评分≥15分、女性AUDIT评分≥13分)的平均每周饮酒次数(χ2=34.89,p0.05)、平均每周饮酒天数(χ2=38.77,p0.05)和平均每次饮酒标准杯(χ2=10.84,p=0.0010.05)均明显高于低分组(7分≤AUDIT评分13/15分)。 5.研究人群(AUDIT评分≥7分)在不同年龄阶段、家庭人均月收入、病人来源的饮酒类型差异具有统计学意义。而在婚姻状况、就业状况、文化程度上饮酒的类型差别无统计学意义。 6.根据AUDIT评分划分两个等级的Beck抑郁评分等级差异具有统计学意义(χ2=27.754,p0.05),且AUDIT等级和Beck抑郁评分等级间存在线性趋势(χ2=23.726,p0.05),可能随着ADUIT评分的增加,抑郁评分等级随之增加,即可能患抑郁程度逐渐增大(U=1072,p0.05)。 7.酒精使用程度严重人群中,饮酒所造成的损害更多集中于生理功能、生理职能上,在躯体疾病的基础上可能进一步发展,进而影响其活力、社会职能和情感职能。 8.AUDIT评分等级的单因素影响分析发现性别、婚姻状况、就业状况对AUDIT评分等级的影响无统计学意义,而年龄、文化程度、收入分组和病人来源等因素对AUDIT评分有统计学意义。AUDIT评分等级的多因素Logistic回归分析：随着年龄的增加可能患酒精使用障碍的风险增大,且45-59岁之间时可能为患病高峰期,此后随着年龄继续增加,酒精使用障碍的患病率无明显改变；高中或中专的中等文化水平为酒精使用程度的危险因素；低收入和高收入水平是酒精使用程度的危险因素。而性别、婚姻状况、工作状况和病人来源在回归模型中无统计学意义。结论 1.酒精使用障碍程度越重,患抑郁症风险越大。 2.酒精使用程度严重人群中,饮酒所造成的损害更多集中于生理功能、生理职能上,在躯体疾病的基础上进一步发展,进而影响其活力、社会职能和情感职能。 3.消化科就诊的中老年人、中等文化水平、低收入或高收入且饮高度白酒的人群考虑为酒精使用障碍的高危人群,作为判断早期干预对象的参考依据。
[Abstract]:objective
1. a survey was conducted to investigate the proportion of patients with alcohol dependence (female AUDIT > 13, male AUDIT > 15) in the Department of Gastroenterology and hospitalization in a certain period of time (AUDIT > 7).
2. to understand the demographic characteristics, drinking patterns and psychological state of the study population (AUDIT > 7).
3. describe the quality of life of the study population (defined as AUDIT > 7) through the SF-36 scale, and assess the psychological status of the subjects by BDI scale.
4. the differences in demographic characteristics, psychological conditions and quality of life were compared between 7 or 15 AUDIT13 or 15 people and a population of alcohol dependent people (female AUDIT > 13, and male AUDIT > 15).
5. understand the influencing factors and risk factors of alcohol use disorders.
Method
This study was a non intervention cross-sectional survey. The survey would collect baseline information for patients seeking medical help in the Department of digestive department or ward of Xiangya No.2 Hospital for physical diseases. Whether their physical diseases were associated with alcohol consumption, the AUDIT scale was used to screen patients to meet the intake conditions and to collect drinking frequency, pattern, drinking behavior and so on. Alcohol related information, and the use of the SF-36 scale to collect the quality of life and the self-assessment of the Beck depression self rating scale. The subjects were selected for risk drinking (defined as: 7 points of female patients < 13 AUDIT score, 7 points for male patients, 15 scores) and patients with alcohol dependence (defined as: female patients. The AUDIT score was more than 13, and the AUDIT score of male patients was more than 15 scores. The difference between the demographic data, the quality of life and the degree of depression among the two groups was compared. The study only conducted a visit and collected the clinical information through the questionnaire and scale of the researcher and the patient's self evaluation. Establish a database and carry out statistical analysis.
Result
1. the Department of Gastroenterology in our hospital may suffer from alcohol use disorder (male AUDIT score more than 15 points, female AUDIT score more than 13) in the outpatient clinic is 5.95%, the ward is 3.05%, and the national survey found that the alcohol dependence prevalence rate is 3.4% in 1993 and 3.8% in 2003, the outpatient is higher than the national alcohol dependence incidence, and the ward is slightly lower than the national; and dangerous drink The proportion of alcohol (7 points less than AUDIT score less than 13/15) was 3.81% and 0.78%. respectively in outpatient and ward.
Among the 149 subjects in the 2. group, 47% of the most frequent Liquors (52 degrees and above) were the most frequent. The remaining ones were beer 26.2%, rice wine / Valley wine 15.4%, and the most common drinking type in the 7 AUDIT13/15 group was beer, the proportion was 50%, the high liquor and rice wine / wine were 25% and 14.6%, while AUDIT > 13/15 was the most popular. The average alcohol consumption is high liquor, the proportion of which is 57.4%, rice wine / grain wine and beer are 15.8% and 14.9%., respectively, and the most frequent alcohol use types are not consistent among the people with different degrees of alcohol use.
The average drinking times per week in the 3. group were 8.31 and 6.19 times per week, up to 30 times, and the average alcohol consumption was between 3-5 standard cups. The number of drinking days around the group was mainly in 10 days and 28 days. It was suggested that the number of drinking days in the group was divided into two groups, and the degree of drinking and drinking between the two groups was between the two groups. And the degree of dependence on alcohol has its own characteristics.
The average weekly drinking times (x 2=34.89, P0.05), average weekly drinking days (x 2=38.77, P0.05) and average drinking standard cup (chi 2=10.84, p=0.0010.05) were significantly higher in 4. AUDIT scores (male AUDIT score or more than 13). The average weekly drinking days (x 2=38.77, P0.05) and average drinking standard cups (chi 2=10.84, p=0.0010.05) were significantly higher than those of the lower group (7 points < AUDIT score 13/15 score).
5. the study population (AUDIT score > 7) was statistically significant at different age stages, per capita monthly income of the family, and the type of drinking type of patient sources, but there was no significant difference in the types of drinking in marital status, employment status and education.
6. according to the AUDIT score, the scores of two grades were statistically significant (x 2=27.754, P0.05), and there was a linear trend between the AUDIT grade and the Beck depression score (P0.05). It may increase with the increase of ADUIT score and the depression score, which can increase the degree of depression (U=1072, p0.0). 5).
7. of the people with severe alcohol use, the damage caused by drinking is more concentrated on the physiological function. On the basis of physical function, it may further develop on the basis of physical disease, and then affect its vitality, social function and emotional function.
The single factor impact analysis of 8.AUDIT scores showed that gender, marital status, and employment status had no significant influence on the grade of AUDIT, while age, educational level, income group and patient source were statistically significant in the.AUDIT score of AUDIT scores: with the increase of age The risk of alcohol use disorders increases and may be the peak period between 45-59 years of age, and the prevalence of alcohol use disorders is not significantly changed as age continues; secondary and secondary school levels in high school or secondary school are risk factors for alcohol use; low income and high income are the risk factors for alcohol use. There was no statistical significance in sex, marital status, work status and patient source in the regression model.
conclusion
1. the more severe alcohol use disorders, the greater the risk of depression.
2. of the people with severe alcohol use, the damage caused by drinking is more concentrated on the physiological function, and the physiological function is further developed on the basis of somatic disease, which affects its vitality, social function and emotional function.
The middle aged and elderly people in the 3. digestive department, medium level, low income or high income and drinking high spirits are considered as the high risk groups of alcohol use barriers as a reference for judging early intervention.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.6

【参考文献】