河南省1327例阻塞性睡眠呼吸暂停低通气综合征患者抑郁状态调查

Research on risk factors of depression symptoms in 1 327 patients with obstructive sleep apneahypopnea syndrome

目的调查河南省阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的抑郁状态并初步分析其相关因素。方法经多导睡眠图（PSG）及临床诊断确诊的OSAHS患者1327例，经症状自评量表（Symptom Checklist90，SCL-90）、抑郁自评量表（Self-rating Depression Scale，SDS）筛选分为不伴抑郁OSAHS患者和伴抑郁OSAHS患者。采用SPSS17．0软件分析呼吸暂停低通气指数（AHI）、缺氧程度、家庭负担问卷得分（Family Burden Scale of Disease，FBS）、家庭关怀指数（Family APGAR Index，APGAR）、患者领悟社会支持量表得分（Perceived Social Support Scale，PSSS）等因素与OSAHS患者抑郁状态的相关性，并进一步探讨家庭及社会因素对抑郁状态的影响。结果经筛选，不伴抑郁OSAHS患者698例，伴抑郁OSAHS患者629例，本研究OSAHS患者抑郁伴发率达47．4％（629／1327）。OSAHS患者抑郁状态与性别、婚姻状况、FBS得分、APGAR指数、AHI指数、PSSS得分及缺氧程度有关；Logistic回归分析提示婚姻状况、APGAR指数、AHI指数、PSSS得分、缺氧程度、高血压、心脏病为OSAHS患者伴发抑郁的独立危险因素。伴发抑郁的OSAHS患者在FBS总分及家庭日常活动、家庭关系和家庭成员心理健康三项因子的评分均大于不伴抑郁OSAHS患者（P值均〈0．05）；APGAR总分及适应度和情感度两项因子评分均小于不伴抑郁OSAHS患者（P值均〈0．05）；PSSS评分均小于不伴抑郁OSAHS患者（P值均〈0．05）。结论河南省OSAHS患者抑郁伴发率较高，其发生与患者婚姻状况、AHI指数、缺氧程度、家庭社会支持及伴发疾病（高血压、心脏病）等因素有较密切的关系。

Objective To investigate the comorbidity rate of depression symptoms in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） in Henan province and to ascertain the risk factors. Methods One thousand three hundred and twenty-seven patients with OSAHS determined by overnight polysomnogram（PSG） were enrolled in this study. After screening the Symptom Checklist 90（SCL-90） and Self-rating Depression Scale （SDS）, the patients were divided into two groups： OSAHS （control group, n =698） and OSAHS ＋ depression （ n = 629 ）. The correlation was explored between the depression symptoms in patients with OSAHS and the sociodemographic variables and health status including smoking, drinking, marital status, apnea hyponea index（AHI）, anoxicity, Family Burden Scale of Disease （FBS） , Family APGAR Index （APGAR）, Perceived Social Support Scale （PSSS） and so on. Furthermore, In-depth analyses were carried out between the depression symptoms in patients with OSAHS and the social and family factor items （FBS, APGAR and PSSS）. Results The comorbidity rate of depression symptoms in patients with OSAHS in Henan province was 47.4%, and was correlated with the gender, marital status, FBS, APGAR, AHI, PSSS and anoxicity. Logistic regression analysis indicated that single marital status, APGAR, AHI, PSSS, hypoxemia and heart disease were all independent risk factors for depression in OSAHS patients. The total of the FBS score and three of its subfactors scores（family daily activities, family relationships and mental health of family members） were higher, and the total of the APGAR score and two of its subfactors scores（ adaptabilith and affection）were lower in OSAHS with depression compared with the control group（P 〈 0.05 ）. Besides, the total score for the PSSS AND Scores for its two subfactors（ family support and social support） were all lower in OSAHS patients with depression than those of the control group （P 〈 0.05）. Conclusion In patients with OSAHS, depression symptoms are common and are associated with marital status, AHI, anoxicity, concomitant diseases （hypertension, heart disease）, concerns and supports from the family and society.