脑损伤患者症状群与急性应激障碍的相关研究

The correlation between symptom clusters and acute stress disorder in patients with brain injury

目的探讨脑损伤相关症状群与急性应激障碍(acute stress disorder,ASD)的关系。方法选取2017年3月至2018年3月于华北理工大学附属医院住院的脑损伤患者301例,采用斯坦福急性应激反应问卷(SASRQ)、颅脑创伤亚量表(BIS)、匹兹堡睡眠质量指数量表(PSQI)对患者进行分析评测。结果301例脑损伤患者发生急性应激障碍的有140例(46.51%),SASRQ得分为(70.78±28.00)分,单因素分析显示年龄(χ2=4.172,P=0.041)、性格类型(χ^2=57.281,P<0.001)、睡眠质量(χ^2=70.785,P<0.001)、住院次数(χ^2=43.547,P<0.001)、抑郁、强迫及敌意症状群在有无ASD的脑损伤患者中均差异有统计学意义(均P<0.05)。抑郁、强迫症状群各个条目与SASRQ得分显著相关(P<0.05);敌意症状群除自己不能控制地大发脾气外,其他条目与SASRQ得分显著相关(r=0.176~0.698,P<0.05)。性格(OR=0.243,95%CI=0.142~0.415)、睡眠障碍(OR=0.072,95%CI=0.029~0.178)、住院次数(OR=0.129,95%CI=0.054~0.306)、抑郁症状群(OR=1.260,95%CI=1.061~1.497)、强迫症状群(OR=1.419,95%CI=1.239~1.625)及敌意症状群(OR=1.253,95%CI=1.058~1.482)是脑损伤患者发生ASD的影响因素(P<0.05)。结论脑损伤患者ASD发生率较高,性格类型、住院情况、睡眠、抑郁症状群、强迫症状群及敌意症状群是其影响因素,应高度重视。

Objective To explore the relationship between brain injury related symptom groups and acute stress disorder(ASD). Methods Totally 301 patients with brain injury hospitalized in the Affiliated Hospital of North China University of Technology from March 2017 to March 2018 were recruited.The patients were assessed by Stanford Acute Stress Response Questionnaire (SASRQ), Brain Trauma Subscale (BIS) and Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of acute stress disorder patients with brain injury was 46.51%(140/301). The SASRQ score of all patients with brain injury was (70.78±28.00). Univariate analysis showed that there were significant differences in age (χ2= 4.172, P=0.041), personality type (χ^2 = 57.281, P<0.001), sleep quality (χ^2= 70.785, P<0.001), hospitalization frequency (χ2= 43.547, P<0.001), depression, obsessive-compulsive and hostile symptoms between patients with and without ASD (P<0.05). The scores of depression and obsessive-compulsive symptoms were significantly correlated with SASRQ scores(P<0.05). The scores of hostility symptoms were significantly correlated with SASRQ scores except for patients who lost their temper uncontrollably (r=0.176-0.698, P<0.05). Personality(OR=0.243, 95%CI=0.142-0.415), sleep disorders(OR=0.072, 95%CI=0.029-0.178), hospitalization times(OR=0.129, 95%CI=0.054-0.306), depressive symptoms(OR=1.260, 95%CI=1.061-1.497), obsessive-compulsive symptoms(OR=1.419, 95%CI=1.239-1.625) and hostile symptoms(OR=1.253, 95%CI=1.058-1.482) were the influencing factors of ASD in patients with brain injury (P<0.05). Conclusion The incidence of ASD is higher in patients with brain injury.Personality type, hospitalization, sleep quality, depressive symptoms, obsessive-compulsive symptoms and hostile symptoms are the influencing factors, which should be paid more attention.