慢性胃炎患者的心理与生活和睡眠质量分析

Analysis on the psychology,life and sleep quality of patients with chronic gastritis

目的分析慢性非萎缩性胃炎(chronic non-atrophic gastritis,CNAG)、慢性萎缩性胃炎(chronic atrophic gastritis,CAG)和肠上皮化生(intestinal metaplasia,IM)患者的社会心理特征与生活和睡眠质量及其影响因素。方法连续纳入2019年6—12月到西京医院就诊的671例慢性胃炎患者,根据活检病理诊断分为CNAG组(136例)、CAG组(180例)、IM组(355例)。分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、生活质量量表(SF-36)、匹茨堡睡眠质量指数量表(PSQI)和应对方式(TCSQ)量表进行评估分析。结果IM组患者的焦虑和抑郁发生率均显著高于CNAG组和CAG组(均P<0.05)。3组患者的生活质量量表各因子评分均低于全国常模评分,IM组生理机能、躯体疼痛、一般健康状况评分均显著低于CNAG组和CAG组(均P<0.05)。IM组和CAG组患者睡眠质量总分均显著高于CNAG组(均P<0.05)。CAG组和IM组积极应对评分均显著低于CNAG组(均P<0.05)。IM组消极应对评分显著高于CNAG组和CAG组(均P<0.05)。进一步分析发现,患者的年龄、性别、文化程度、HP感染状态和病程都能够影响慢性胃炎患者的焦虑和抑郁发生率以及睡眠质量,年龄、文化程度和性别可能与患者生活质量相关,而文化程度和年龄与患者积极应对方式的改变有关。结论慢性胃炎患者焦虑和抑郁发生率随黏膜病变的加重显著升高,生活和睡眠质量显著下降,对事物的应对方式趋于消极。提示临床上应关注慢性胃炎患者的精神心理状态与生活和睡眠质量,必要时给予相应干预。

Objective To analyze the psychosocial characteristics,life and sleep quality of chronic non-atrophic gastritis(CNAG),chronic atrophic gastritis(CAG)and intestinal metaplasia(IM)patients and their related factors.Methods A total of 671 patients with chronic gastritis who visited the outpatient department of Xijing hospital from June to December 2019 were enrolled.According to biopsy pathological diagnosis,they were divided into CNAG group(136 cases),CAG group(180 cases)and IM group(355 cases).Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),quality of life scale(SF-36),Pittsburgh sleep quality index(PSQI)and coping style(TCSQ)were used for assessment and analysis.Results The incidence rates of anxiety and depression in the IM group were significantly higher than those in the CNAG group and the CAG group(all P<0.05).The scores of all factors of the quality of life scale of the three groups were lower than the national norm scores in three groups.The scores of physiological function,body pain and general health condition of the IM group were significantly lower than those of the CNAG group and the CAG group(all P<0.05).The total score of sleep quality in both the IM group and the CAG group was significantly higher than that in the CNAG group(all P<0.05).The positive coping scores of both the CAG group and the IM group were significantly lower than those of the CNAG group(all P<0.05).The negative coping score of the IM group was significantly higher than that of the CNAG group and the CAG group(both P<0.05).Further analysis found that the patient’s age,gender,education level,HP infection status and course of disease could affect the anxiety and depression incidence and sleep quality of patients with chronic gastritis,age,education level and gender may be related to the patient’s quality of life.Among them,education level and age were related to changes in patients’active coping style.Conclusion With the aggravation of chronic gastritis mucosal lesions,the incidence of anxiety and depression in patients significantly increased,the quality of life and sleep quality significantly decreased,and the way of coping with things tends to be negative.It is suggested that clinical attention should be paid to the mental state,life and sleep quality of patients with chronic gastritis,and appropriate intervention should be given when necessary.