慢性荨麻疹患者焦虑、抑郁情绪及其对服药依从性的影响研究

发布时间：2018-08-17 13:54

【摘要】：目的:研究慢性荨麻疹患者焦虑、抑郁情绪,探讨可能对其发生、发展产生影响的因素;为临床识别易于发生焦虑、抑郁情绪的慢性荨麻疹患者提供线索。观察慢性荨麻疹患者服药依从性,探究焦虑、抑郁情绪对慢性荨麻疹患者服药依从性的影响,引起对慢性荨麻疹患者焦虑、抑郁情绪的重视。研究方法:收集江苏大学附属医院2015年2月至2016年12月间门诊就诊的慢性荨麻疹患者。按照一般就诊流程采集相关病史信息,行必要的实验室检查,包括自体血清皮肤试验及变应原检测试验等。按照纳入排除标准筛选患者,经知情同意后纳入调查,记录一般情况及相关临床信息,在调查人员指导下由患者独立填写《荨麻疹活动性评分》评估疾病活动性,由患者独立完成《综合性医院焦虑、抑郁量表》评估焦虑、抑郁情绪。两周后对接受标准治疗的慢性荨麻疹患者进行回访,以《Morisky服药依从性问卷》评估服药依从性。调查结束后应用Excel 17.0软件整理所有数据并建立数据库、SPSS 22.0统计软件统计分析《综合性医院焦虑、抑郁量表》得分,描述慢性荨麻疹患者焦虑、抑郁情绪的发生概况,并将其与中国常模对比;根据一般情况及相关临床信息、实验室检查结果将患者分组,分析焦虑、抑郁的相关因子;比较检出焦虑、抑郁情绪的慢性荨麻疹患者与未检出者在服药依从性上有无差异。相应的数据比较分析行t检验、卡方检验、秩和检验、二元logistic回归分析等,以P㩳0.05视为存在显著统计学意义。结果:研究共纳入138例慢性荨麻疹患者,与常模对比慢性荨麻疹患者焦虑、抑郁情绪水平均高,且存在显著统计学差异(p㩳0.05)。单因素分析显示:性别、年龄、婚姻、生育情况、教育程度、病程、生活事件、血管性水肿与焦虑情绪相关,存在统计学意义(p㩳0.05),二元logistics回归分析显示性别、病程、血管性水肿是独立的危险因素;性别、年龄、生育情况、生活事件、血管性水肿与抑郁情绪相关,且有统计学意义(p㩳0.05),二元logistics回归分析显示性别、血管性水肿是独立的危险因素。受调查的慢性荨麻疹患者整体服药依从性不理想,存在焦虑、抑郁情绪的慢性荨麻疹患者服药依从性与未检出者相比《Morisky服药依从性问卷》评分及评级均差,且差异有显著统计学意义(p㩳0.05)。结论:女性、青年、近1年内经历生活事件、有血管性水肿症状是焦虑、抑郁情绪共同的高危因素。此外,未婚、未生育、高等教育背景、病程1年内是焦虑情绪的危险因素,而已生育则是抑郁情绪的高危因素。在临床工作中以上群体的慢性荨麻疹患者应当格外注意发生焦虑、抑郁情绪的可能,推荐使用《综合性医院焦虑、抑郁量表》对其进行进行焦虑、抑郁情绪的筛查。慢性荨麻疹患者的服药依从性尚不理想,因焦虑、抑郁情绪显著降低患者服药依从性,需要注重对伴有焦虑、抑郁者的服药督促,防治因不依从造成的疗效不理想。
[Abstract]:Objective: to study anxiety and depression in patients with chronic urticaria and to explore the factors that may affect their occurrence and development, and to provide clues for clinical identification of patients with chronic urticaria who are prone to anxiety and depression. To observe the drug compliance of patients with chronic urticaria and explore the influence of anxiety and depression on the compliance of patients with chronic urticaria, and to pay attention to the anxiety and depression of patients with chronic urticaria. Methods: patients with chronic urticaria from February 2015 to December 2016 were collected from affiliated Hospital of Jiangsu University. Collect the relevant medical history according to the general procedure, carry out necessary laboratory examination, including autologous serum skin test and allergen test, etc. According to the exclusion criteria, the patients were screened and investigated after informed consent, and the general information and related clinical information were recorded. Under the guidance of the investigators, the patients independently filled out the "Urticaria activity score" and evaluated the disease activity. The anxiety and depression were evaluated by the comprehensive hospital anxiety and depression scale. Two weeks later, patients with chronic urticaria who received standard treatment were interviewed and evaluated with the < Morisky compliance questionnaire >. After the investigation, all the data were sorted out by using Excel 17.0 software and a database was established. The statistical analysis software < General Hospital anxiety and Depression scale > was used to describe the occurrence of anxiety and depression in patients with chronic urticaria. According to the general situation and related clinical information, the patients were divided into groups and analyzed the related factors of anxiety and depression. There was no difference in drug compliance between chronic urticaria patients with depression and undetected urticaria patients. The corresponding data were compared and analyzed with t test, chi-square test, rank sum test and binary logistic regression analysis. Results: 138 patients with chronic urticaria were enrolled in the study. Compared with the norm, the anxiety and depression levels of the patients with chronic urticaria were significantly higher than those of the control group (p0.05). Univariate analysis showed that sex, age, marriage, fertility, education level, course of disease, life events, vascular edema and anxiety were significantly correlated (p0. 05). Binary logistics regression analysis showed gender, course of disease. Vascular edema was an independent risk factor, sex, age, fertility, life events and vascular edema were significantly correlated with depression (p0. 05). Binary logistics regression analysis showed that Vascular edema was an independent risk factor. The overall compliance of patients with chronic urticaria was not satisfactory, anxiety, depression in patients with chronic urticaria patients with drug compliance than those without detection of the < Morisky compliance questionnaire > score and rating mean difference. The difference was statistically significant (p0.05). Conclusion: women, young people, experienced life events within one year, vascular edema symptoms are the common high risk factors of anxiety and depression. In addition, unmarried, childless, higher education background, course of disease within one year are the risk factors of anxiety, but fertility is the high risk factor of depression. In clinical work, the patients with chronic urticaria in the above groups should pay special attention to the possibility of anxiety and depression. It is recommended to use the General Hospital anxiety and Depression scale to screen them for anxiety and depression. The drug compliance of patients with chronic urticaria is not ideal, because of anxiety, depression significantly reduce the patients' compliance, need to pay attention to the patients with anxiety, depression drug supervision, prevention and treatment of non-compliance caused by the efficacy is not ideal.
【学位授予单位】：江苏大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.24

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