CAJ | 학술논문

目的探讨认知行为干预对狼疮性肾炎患者焦虑/抑郁情绪及生存质量的影响。方法采用健康状况问卷(SF-36)；采用世界卫生组织生存质量测定量表简表评估113例狼疮性肾炎患者的生存质量，分别用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)及狼疮性肾炎疾病活动性指数量表评估患者抑郁、焦虑症状及狼疮性肾炎疾病活动性指数，并将其分为抑郁、焦虑组与非抑郁、焦虑组。将抑郁、焦虑组患者随机分为认知行为干预组和非认知行为干预组，认知行为干预组在常规治疗的基础上给于针对性认知行为干预；非认知行为干预组仅给予常规治疗,并比较两组间生活质量、抑郁/焦虑情绪及狼疮性肾炎疾病活动性指数的差异。结果狼疮性肾炎患者抑郁、焦虑情绪的发生率分别为24.78豫(28/113)和44.25豫(50/113)。抑郁、焦虑症状评分与生存质量4项指标全部呈负相关,尤其在认知行为领域、生理领域、社会关系领域三项指标中差异显著(r分别为-0.287/-0.312,-0.300/-0.351,-0.418/-0.404；均<0.01)，而与狼疮性肾炎疾病活动性指数呈显著正相关。认知行为干预治疗后认知行为干预组生存质量总分[(79.66±9.30)分vs(53.43±11.20)分，<0.01]明显高于非认知行为干预组；HAMA评分[(8.32±7.45)分vs(15.09±6.41)分，=0.000]、HRSD评分[(7.45±7.97)分vs(20.87±6.76)分，<0.01]、LNDAI评分[(1.15±4.38)分vs(6.83±5.30)分，<0.01]明显低于非认知行为干预组。结论狼疮性肾炎患者抑郁、焦虑情绪发生率较高，且与患者生存质量密切相关。针对性的认知行为干预治疗可明显改善狼疮性肾炎患者的抑郁、焦虑症状及狼疮性肾炎的疾病活动性指数，提高患者的生存质量，从而提高狼疮性肾炎的治疗效果。
목적탐토인지행위간예대랑창성신염환자초필/억욱정서급생존질량적영향。방법채용건강상황문권(SF-36)；채용세계위생조직생존질량측정량표간표평고113례랑창성신염환자적생존질량，분별용한밀이돈억욱량표(HAMD)、한밀이돈초필량표(HAMA)급랑창성신염질병활동성지수량표평고환자억욱、초필증상급랑창성신염질병활동성지수，병장기분위억욱、초필조여비억욱、초필조。장억욱、초필조환자수궤분위인지행위간예조화비인지행위간예조，인지행위간예조재상규치료적기출상급우침대성인지행위간예；비인지행위간예조부급여상규치료,병비교량조간생활질량、억욱/초필정서급랑창성신염질병활동성지수적차이。결과랑창성신염환자억욱、초필정서적발생솔분별위24.78예(28/113)화44.25예(50/113)。억욱、초필증상평분여생존질량4항지표전부정부상관,우기재인지행위영역、생리영역、사회관계영역삼항지표중차이현저(r분별위-0.287/-0.312,-0.300/-0.351,-0.418/-0.404；균<0.01)，이여랑창성신염질병활동성지수정현저정상관。인지행위간예치료후인지행위간예조생존질량총분[(79.66±9.30)분vs(53.43±11.20)분，<0.01]명현고우비인지행위간예조；HAMA평분[(8.32±7.45)분vs(15.09±6.41)분，=0.000]、HRSD평분[(7.45±7.97)분vs(20.87±6.76)분，<0.01]、LNDAI평분[(1.15±4.38)분vs(6.83±5.30)분，<0.01]명현저우비인지행위간예조。결론랑창성신염환자억욱、초필정서발생솔교고，차여환자생존질량밀절상관。침대성적인지행위간예치료가명현개선랑창성신염환자적억욱、초필증상급랑창성신염적질병활동성지수，제고환자적생존질량，종이제고랑창성신염적치료효과。
Objective To investigate the ef ect of cognitive-behavioral therapy on the anxiety or depression and the quality of life of patients with lupus nephritis.Methods 113 patients with lupus nephritis (LN) quality of life were evaluated The World Health Organization quality of life questionnaire (WHOQOL-BREF). Depression and anxiety and lupus nephritis disease activity index(LNDAI)were estimated by Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) and LNDAI rating scale respectively. Al the patients were divided into anxiety or depression group and non-anxiety or depression group. Patients of anxiety or depression group were divided randomly into cognitive-behavioral therapy group and non- cognitive-behavioral therapy group. Patients of anxiety or depression group were treated with cognitive-behavioral therapy in addition to routine treatment. Patients of non-cognitive-behavioral therapy group were treated only with routine treatment. Quality of life and depression/anxiety mood and 21.95%and 41.46%LNDAI were recompared between two groups. Results Incidence of depression and anxiety is respectively of patients with LN. Depression and anxiety scores were negatively cor elated with total out of 4 scales WHOQOL-BREF. Two groups had significantly dif erence especial y psychological domain and physical domain and social relation domain (r is-0. 287/-0.312, -0.300/-0.351,-0.418/-0.404;P <0.01),With lupus nephritis disease activity index (LNDAI) was significantly positively related (r is 1.510/1.474; <0.01). After treatment , anxiety or depression group’total score of quality of life(QOL)[(79.66±9.30)vs(53.43±11.20),<0.01]were significantly higher than those of non-anxiety or depression group. HAMA[(8.32±7.45)vs(15.09± 6.41),<0.01]and HAMD [(7.45±7.97)vs (20.87±6.76),<0.01]and LNDAI [(1.15±4.38)vs (5.83±5.30),<0.01]were lower than those of non-anxiety or depression group. Conclusion Incidence of anxiety or depression were high in LN patients,which had close association with QOL and LNDAI. The cor esponding cognitive-behavioral therapy could improve anxiety or depression symptoms ef ectively and improve LN patients’QOL and LNDAI.Also it could improve therapeutic ef ect of LN.