应用累积比数回归模型分析癫痫患者抑郁状况的影响因素

Application of Ordinal Logistic Regression Analysis in Determining Risk Factors of Depression in Patients with Epilepsy

目的对影响癫痫患者伴发抑郁状况的各种因素进行分析,为癫痫防治提供基础数据。方法采用抑郁自评量表(CES-D)调查患者的抑郁伴发情况,应用多分类有序累积比数logistic回归对患者的抑郁患病率及其影响因素进行单因素和多因素分析。结果 874例癫痫伴发抑郁的患者中,轻、中、重度抑郁患病率分别为5.95%、8.70%与15.33%。本研究地区未施加干预癫痫患者的抑郁患病率为40.3%(95%CI:35.7%～44.9%),经综合干预后抑郁患病率降为24.4%(95%CI:20.4%～28.8%)。年龄、发作频率、文化程度和癫痫知识掌握程度是伴发抑郁的主要影响因素。其中,发作频率与年龄是伴发抑郁的危险因素;癫痫知识掌握较好与文化程度是伴发抑郁的保护因素。结论应针对重点人群、重点可干预影响因素加强干预,开展针对性心理疏导与干预、规范治疗和健康促进以降低癫痫患者的抑郁患病率。

Objective To analyze and discuss the various fac- tors affecting the situation of anxiety in patients with epilepsy. Methods Utilize the Depression Scale（CES-D） to investigate the Prevalence of epi- lepsy patients with anxiety, using ordinal logistic regression to analysis the influencing factors in patients with anxiety for univariate and multivariate statistical analysis. Results 874 cases of epilepsy associated with anxiety in patients with mild, moderate, severe anxiety prevalence was 5.95 %, 8.70% and 15.33%. Study on the prevalence of anxiety in patients with epilepsy not intervention in 40. 3 % （95 % CI：35.7% -44. 9% ）, the preva- lence of anxiety after the intervention reduced to 24. 4% （95 % CI：20. 4% - 28.8% ）. Age, seizure frequency, educational level and epilepsy degree of knowledge is the main factors associated with depression. Among them, sei- zure frequency and age of depression is associated with risk factors ; epilep- sy better knowledge and education level of protective factors is associated with depression. Conclusion For the focus groups, we should focus on the impact of interventions factors scaling up of interventions to carry out targeted psychological counseling and intervention, the specification of the preferred single-agent treatment and health promotion to reduce the preva- lence of epilepsy patients with anxiety. The modeling approach has the sci-entific effectiveness.