痛风患者治疗效果与心理状况相关性分析

Analysis of the correlation between the therapeutic effect and psychological status of gout patients

目的探讨痛风患者的治疗效果与心理状况相关性,为临床治疗及生活质量改善提供参考。方法选取2018年9月~2019年9月惠州市中心人民医院确诊的200例痛风患者为研究对象,规范化应用药物治疗20周后,治疗前后评估患者的治疗效果指标,主要包括痛风临床症状积分评估、空腹血尿酸水平、红细胞沉降率、C反应蛋白(CRP)、超声影像改变指标,监测肝肾功指标变化评估药物安全性及心理状况评估,探究痛风患者治疗效果与心理状况间的相关性。结果治疗前后患者的血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平比较,差异无统计学意义(P>0.05);治疗后尿素氮(BUN)、肌酐、血尿酸水平、滑膜厚度及焦虑自评表(SAS)评分、抑郁自评表(SDS)评分低于治疗前,差异均有统计学意义(P<0.05);治疗后超声结果的滑膜厚度低于治疗前,血流信号血管翳阻力指数(RI)高于治疗前,差异有统计学意义(P<0.05);治疗后,SAS、SDS评分与BUN、肌酐、血尿酸水平及滑膜厚度成正相关,与滑膜血流信号RI成负相关(P<0.05)。结论采用非布司他联合塞来昔布治疗,患者的临床症状、炎症指标、血尿酸水平及超声影像结果、心理状态均有明显的改善。

Objective To explore the correlation between the therapeutic effect and psychological status of gout patients,and to provide reference for their clinical treatment and quality of life improvement.Methods From September 2018 to September 2019,200 patients diagnosed as gout in Huizhou Central People′s Hospital were selected as the research objects.After 20 weeks of standardized application of drugs,the therapeutic effect indexes of patients were evaluated before and after treatment,mainly including clinical symptom integral evaluation of gout,fasting blood uric acid level,erythrocyte sedimentation rate,C-reactive protein,ultrasonic image change indexes,monitoring liver and kidney function indexes to evaluate the drug safety and psychological status of patients with gout,and explore the correlation between the therapeutic effect and psychological status.Results There were no significant differences in serum alanine aminotransfease(ALT)and aspartate aminotransferase(AST)between the two groups before and after treatment(P>0.05).After treatment,the levels of urea nitrogen(BUN),creatinine,uric acid,synovium thickness,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were lower than those before treatment(P<0.05);after treatment,the synovial thickness was lower than that before treatment,and the blood flow signal pannus resistance index(RI)was higher than that before treatment(P<0.05).SAS and SDS scores were positively correlated with BUN,creatinine,serum uric acid and synovial thickness,and negatively correlated with RI(P<0.05).Conclusion The clinical symptoms,inflammatory indexes,serum uric acid level,ultrasound imaging results and psychological state of patients treated with Febuxostat combined with celecoxib were significantly improved.