CAJ | 학술논문

目的探讨冠心病支架置入术后胸痛患者躯体症状与焦虑、抑郁的相互关系.方法采用随机抽样方法从北京安贞医院心内科门诊患者中选取冠心病支架置入术后再发胸痛患者536例,采用医院焦虑抑郁量表(HADS)和患者健康问卷(PHQ-15)进行调查,统计焦虑、抑郁检出率及不同程度躯体症状患者焦虑、抑郁患病相对危险度.结果 536例患者中,焦虑、抑郁及焦虑合并抑郁检出率分别为16.6％(89例)、25.4％(136例)、27.2％(146例).躯体症状与焦虑、抑郁的相关分析显示,PHQ-15总分、PHQ-15阳性症状数目与HADS总分(r=0.413,P＜0.01;r =0.375,P＜0.01)、HADS-a因子分(r=0.484,P＜0.01;r =0.428,P＜0.01)及HADS-d因子分(r=0.381,P＜0.01;r=0.299,P＜0.01)呈正相关.躯体症状轻度(PHQ-15,5～9分)、中度(PHQ-15,10 ～ 14分)、重度(PHQ-15,15 ～ 30分)患者焦虑患病的相对危险度(RR)及95％置信区间(CI)分别为6.42(1.88 ～9.79)、14.83(6.01 ～28.59)、27.23(19.23 ～41.03);抑郁患病的RR(95％CI)分别为3.21(0.98 ～3.89)、18.29(9.37 ～25.16)、42.53(9.14 ～87.26);焦虑、抑郁合并患病的RR(95％CI)分别为3.96(1.29 ～ 8.06)、11.12(5.12 ～26.47)、34.73(16.13 ～81.28).结论心内科门诊冠心病支架置入术后再发胸痛为主要躯体症状就诊的患者焦虑、抑郁常见;躯体症状与焦虑、抑郁密切相关,躯体症状程度越重数目越多,患焦虑、抑郁相对危险度越高.
목적 탐토관심병지가치입술후흉통환자구체증상여초필、억욱적상호관계.방법 채용수궤추양방법종북경안정의원심내과문진환자중선취관심병지가치입술후재발흉통환자536례,채용의원초필억욱량표(HADS)화환자건강문권(PHQ-15)진행조사,통계초필、억욱검출솔급불동정도구체증상환자초필、억욱환병상대위험도.결과 536례환자중,초필、억욱급초필합병억욱검출솔분별위16.6％(89례)、25.4％(136례)、27.2％(146례).구체증상여초필、억욱적상관분석현시,PHQ-15총분、PHQ-15양성증상수목여HADS총분(r=0.413,P＜0.01;r =0.375,P＜0.01)、HADS-a인자분(r=0.484,P＜0.01;r =0.428,P＜0.01)급HADS-d인자분(r=0.381,P＜0.01;r=0.299,P＜0.01)정정상관.구체증상경도(PHQ-15,5～9분)、중도(PHQ-15,10 ～ 14분)、중도(PHQ-15,15 ～ 30분)환자초필환병적상대위험도(RR)급95％치신구간(CI)분별위6.42(1.88 ～9.79)、14.83(6.01 ～28.59)、27.23(19.23 ～41.03);억욱환병적RR(95％CI)분별위3.21(0.98 ～3.89)、18.29(9.37 ～25.16)、42.53(9.14 ～87.26);초필、억욱합병환병적RR(95％CI)분별위3.96(1.29 ～ 8.06)、11.12(5.12 ～26.47)、34.73(16.13 ～81.28).결론 심내과문진관심병지가치입술후재발흉통위주요구체증상취진적환자초필、억욱상견;구체증상여초필、억욱밀절상관,구체증상정도월중수목월다,환초필、억욱상대위험도월고.
Objective To investigate the prevalence of anxiety,depression and somatic symptoms status,and to explore the relation between somatic symptoms of anxiety and depression.Methods Within a sectional survey,536 outpatients were tested with the hospital anxiety and depression scale(HADS) and the patient health questionnaire-15 (PHQ-15).Prevalence of anxiety and depression,relative risks(RR) of anxiety and depression in patients with different severity somatic symptoms were investigated.Results Prevalence rates of anxiety,depression and anxiety combined with depression were 16.6％ (89/536),25.4％ (136/536) and 27.2％ (146/536) respectively in the 536 outpatients.Significant positive correlations were observed among PHQ-15 scores,PHQ-15 positive symptom numbers andHADS sores (r=0.413,P＜0.01;r =0.375,P＜0.01),HAD-a sores (r=0.484,P ＜ 0.01 ; r =0.428,P ＜ 0.01),HAD-d sores (r =0.381,P ＜ 0.01 ; r =0.299,P ＜ 0.01).Relative risks (RR) and 95％ confidence intervals (CI) for patients with anxiety of low PHQ-15 scores(5-9),medium PHQ-15 scores (10-14) and high PHQ-15 scores (15-30) were 6.42 (1.88-9.79),14.83 (6.01-28.59),27.23 (19.23-41.03) respectively; RR(95％ CI) for patients with depression was 3.21 (0.98-3.89),18.29(9.37-25.16) and 42.53(9.14-87.26) respectively; RR (95％ CI) for patients with anxiety combined with depression was 3.96 (1.29-8.06p),11.12(5.12-26.47),34.73(16.13-81.28) respectively.Conclusions There is a high prevalence of anxiety and depression in cardiology coronary stent implantation outpatients.A positive correlation is observed among anxiety,depression and somatic symptoms.