203例农村有偿献血感染HIV患者抑郁障碍及生活质量调查

Depression and Quality of Life Investigation among HIV/AIDS Subjects Infected by Plasma Donation

目的:调查通过献血途径感染人类免疫缺陷病毒(HIV)的203例患者的情绪状况及生活质量。方法:采用贝克抑郁问卷、复合性国际诊断用检查提纲和SF-36对203例通过献血途径感染HIV的患者(HIV阳性组)及年龄、性别和受教育年限相匹配的198例HIV阴性献血者进行调查。结果:①HIV阳性组献血次数多于HIV阴性组(52.2±95.4/13.2±23.9,P<0.001),已婚者少于HIV阴性组(88.6%/ 95.5%,P=0.020),丧偶者多于HIV阴性组(10.9%/4.5%,P=0.020),失业率高于HIV阴性组(21.7%/4.0%,P<0.001),前一年全年工作时间少于HIV阴性组(5.0±3.5/7.5±3.0,P<0.001),家庭月收入低于HIV阴性组(476.3±412.7/709.9±513.7,P<0.001)。②HIV阳性组被诊断为获得性免疫缺陷综合征(AIDS)者占56.6%。HIV阳性组抑郁症的终生患病率为13.8%,HIV阴性组的终生患病率为5.1%。HIV阳性组的抑郁总分(11.3±11.3/6.6±9.6)、躯体(3.3±2.9/2.0±2.6)和非躯体因子分(8.0±8.8/4.6±7.4)均高于HIV阴性组(P<0.001)。HIV阳性组达轻度抑郁以上者占40.4%。HIV阳性组已制定自杀计划者高于HIV阴性组(8.4%/3.0%,P<0.05)。HIV阳性组总体生理健康(48.3±9.7/ 55.5±7.0)和心理健康(48.8±8.9/55.1±7.8)得分均低于HIV阴性组(P<0.001)。③HIV阳性组的贝克抑郁问卷总分与T细胞亚群CD4细胞计数无显著相关,与总体生理健康及心理健康呈显著负相关(r=- 0.46～0.68,P<0.001)。结论:HIV阳性患者生存状况较差。对HIV阳性感染者而言,抑郁给患者生活质量造成全面的影响,抑郁和自杀风险仍然是需要干预和处理的问题。

Objective： To investigate the depression and quality of life among HIV positive subjects infected by plasma donation. Method： We recruited 203 HIV positive subjects infected by plasma donation and employed CIDI and BDI questionnaires, as well as SF-36. 198 HIV negative plasma donors were match in gender, age and years of schooling. Results： The lifetime total number of plasma donation of HIV positive group was larger than that of HIV- negatiue group （ 52. 2 ±95.4/13.2 ±23.9, P 〈0. 001 ） . There were less married people and more widowed people in HIV positive group than HIV negative group （10. 9%/4. 5%, P = 0.020 ） . More people were unemployed （21.7%/4. 0% ） and work less months （5.0 ±3.5/7.5 ±3.0） in last year in HIV positive group than HIV negative group （P 〈0. 001 ） . 56.6% were diagnosed as AIDS among 203, HIV positive subjects. The lifetime prevalence of depression of HIV positive group was 13. 8% , compared with 5.1% of HIV negative group. HIV positive subjects got higher BDI total score （ 11.3 ± 11.3/6. 6 ± 9. 6 ）, somatic score （ 3.3 ± 2. 9/2.0 ± 2. 6 ） and non-somatic score （ 8.0 ± 8. 8/4. 6 ± 7.4 ） than HIV negative subjects （ P 〈 0. 001 ） . The percentage of HIV positive subjects whose BDI ≥ 10 was 40. 4%. HIV positive subjects had lower PHSS （ 48.3 ± 9. 7/55.5 ± 7.0 ） and MHSS （ 48.8 ± 8.9 / 55.1 ± 7.8） than HIV negative subjects P 〈 0. 001 ） . The ratio of people who had a plan for suicide of HIV positive group was higher than that of HIV negative group （ 8.4%/3.0%, P 〈 0. 05 ） . Finally, the BDI total score of HIV positive was not associated with CD4 count, but with PHSS and MHSS （ r = - 0. 46 - 0. 68, P 〈 0. 001 ） . Conclusion ： The life status of the HIV positive is not good. The immune system of some AIDS subjects is rebuilt. Depression influences qualify of life in all aspects and must be handled as best as possible, as well as the risk of suicide.