难治性功能性消化不良及其亚型患者的抑郁焦虑状况及其对生活质量影响的调查

Depression and anxiety in patients with refractory functional dyspepsia and their subtypes and their effects on the quality of life

目的调查难治性功能性消化不良(RFD)患者的抑郁焦虑状况及其对生活质量的影响。方法采用多中心、前瞻性设计,对象来自2012年5月至9月广东3家三甲医院消化内科门诊经罗马Ⅲ标准确诊的FD及同期医院的健康志愿者,并分析17项汉密尔顿抑郁量表(HAMD)、14项汉密尔顿焦虑量表(HAMA)及生活质量指数(NDI-QOL)等指标。结果 1 341例完成问卷调查的FD患者中,难治性FD(RFD)和非难治性FD(NRFD)分别为24.3%和75.7%。1RFD在抑郁率、焦虑率、抑郁及焦虑严重程度,HAMD、HAMA量表得分均显著高于NRFD和健康人(P<0.05);2RFD亚型中RFD-EPS+PDS型在抑郁率、焦虑率及HAMD、HAMA得分、中/重度抑郁率、重度焦虑率、抑郁合并焦虑发生率方面均显著高于RFD-EPS型(P<0.05);3RFD在生活质量指数四个区域的得分均显著低于NRFD(P<0.05),不同亚型在生活质量指数干扰区域得分中RFD-EPS+PDS显著低于EPS型(P<0.05)。结论 RFD多伴发抑郁、焦虑,且程度严重,患者生活质量明显下降。

Objective To explore the effects of refractory functional dyspepsia（RFD） on the depression anxiety status and quality of life. Methods A multi-center, prospective trial was admitted. The patients who conformed according to Rome Ⅲ criteria for FD and the healthy control volunteers were recruited from gas-troenterology outpatient in 3 hospitals in Guangdong province during May to September in 2012.The 17-item Hamilton Depression Rating Scale （HAMD）, 14-item Hamilton Anxiety Rating Scale （HAMA）, and Nepean Dyspepsia index-quality of life（NDI-QOL）were respectively used to analyze the depression, anxiety, and the quality of life. Results There were 1,341 FD patients finished the questionnaires, including 327 RFD and 1, 014 NRFD. Significantly higher rate of depression, anxiety, HAMD and HAMA scores was found in RFD than those in NRFD and the healthy controls （P〈0.05）. Among the RFD subtypes, higher rate of depression, anxi-ety, HAMD and HAMA scores, medium and severe depression, severe anxiety, depression and anxiety were found in RFD-EPS＋PDS than RFD-EPS （P〈0.05）. In four regions of the quality of life index scores, RFD was significantly lower than NRFD （P〈0.05）, and the RFD-EPS＋PDS was significantly lower than RFD-EPS in the interference region （P〈0.05）. Conclusion There was high incidence for RFD patients with severe de-pression and anxiety. Moreover, the quality of life was significantly decreased.