黑色素瘤患者使用大剂量干扰素治疗前后抑郁情绪的调查研究

Investigation of depression before and after treatment with interferon among patients with melanoma

目的调查初次使用大剂量重组人干扰素以b注射液治疗后，患者抑郁情绪的变化趋势。方法采用抑郁自评量表（SDS）查问卷及电话随访相结合的方式，对44例黑色素瘤患者的行调查。结果重组人干扰素α2b注射液治疗开始前44例患者的SDS评分（33．8±9．15）分，有抑郁症状的患者占15．9％（7／44），其中轻度抑郁者占9．0％（4／44）；中度抑郁者占4．5％（2／44）；无重度抑郁患者。治疗1周后，44例患者中出现6份无效问卷，剩余38例SDS评分（34．6±8．01）分，有抑郁症状的患者占21．0％（8／38），其中轻度抑郁者占10．55％（4／38）；中度抑郁者占5．2％（2／38）；无重度抑郁患者。治疗后1个月，38例患者中又出现8份无效问卷，剩余30例患者SDS评分（38．2±7．38）分，有抑郁症状的患者占30．0％（9／30），其中轻度抑郁者占20．0％（6／30）；中度抑郁者占6．6％（2／30）；无重度抑郁患者。重组人干扰素α2b注射液治疗前与治疗后1周的SDS评分比较，差异无统计学意义（t=1．62，P〉0．05）；治疗前与治疗后1个月的SDS评分比较，差异有统计学意义（t=3．59，P〈0．05）；治疗后1周与治疗后1个月的SDS评分比较，差异无统计学意义（t=0．46，P〉0．05）。结论护理人员对初次使用重组人干扰素α2b注射液治疗的黑色素瘤患者的干预中，应注重观察患者抑郁情绪的反应，根据抑郁情绪出现的不同时段，给予必要的心理疏导。建立支持性环境，提高患者的生活质量，可在一定程度上预防和减轻患者的抑郁情绪。

Objective To investigate the depression before and after treatment with the initial use of large dosage interferon alpha （INTRONA） among patients with melanoma. Methods The Self-rating DepressionScale （SDS） were used to survey 44 patients with melanoma by filling the questionnaires and follow-up telephone. Results The SDS score of the 44 patients before treatment with INTRONA was （ 33.8 ＋ 9. 15 ）, within which 15.9% （7/44） patients had depression, 9.0% （4/44） patients had mild depression, 4.5% （2/44） patients had moderate depression, no patient had severe depression. After one week treatment with INTRONA, the SDS score was （34.6 ＋ 8.01 ）, within which 21.0% （8/38） patients had depression, 10.55% （4/38） patients had mild depression, 5.2% （2/38） patients had moderate depression, no patient had severe depression. After 1 month treatment with INTRONA, the SDS score of 30 effective questionnaire was （38.2 ~ 7.38）, within which 30.0% （9/30） patients had depression, 20. 0% （6/30） patients had mild depression, 6.6% （2/30） patients had moderate depression, no patient had severe depression. The score of SDS before treatment and one week after treatment had no significant difference （t = 1.62, P 〉 0.05 ）. The score of SDS before treatment and one month after treatment had significant difference （ t = 3.59,P 〈 0.05 ）. The score of SDS one week and one month after treatment had significant difference （t = 0. 46, P 〉 0.05 ）. Conclusions For the patients with the initial use of INTRONA, the nurses should pay attention to observe patients＇ reaction of depression. According to the different periods of depression, the psychological intervention was necessary. Building a supportive environment and improving the patients＇ quality of life can prevent and reduce the depressive mood to a certain extent.