激素使用对系统性红斑狼疮患者心理健康的影响分析

Effect of glucocorticoid on mental health in SLE patients

目的探讨激素使用对系统性红斑狼疮患者心理健康的影响。方法随机选择郑州大学第一附属医院2017年11月至2020年7月收治的314例已经确诊的狼疮患者,根据目前使用激素剂量分为无激素组、小剂量激素组和中大剂量激素组。采用症状自评量表SCL-90分析激素使用对狼疮患者心理健康的影响。结果本研究共纳入已确诊的狼疮患者314例,服用小剂量激素者141例(44.9%);各组患者平均使用激素剂量分别为0 mg、(4.1±2.2)mg、(15.1±9.1)mg。在中大剂量激素组,SCL-90得分≥160分31例,占30.4%,人际关系、抑郁、焦虑、敌对、精神病性、睡眠饮食因子分均明显高于其他两组患者,差异具有统计学意义(P<0.05);而使用中大剂量激素组患者在SCL-90总分、人际关系、抑郁、焦虑、敌对、恐怖、精神病性均显著高于2006年全国常模(P<0.003或P<0.0001)。结论狼疮患者存在不同程度的心理障碍,激素使用量是心理健康的重要影响因素,在临床诊治过程中应密切关注患者的心理状态,及时减量或停用激素。

Objective To investigated the effect of glucocorticoid dose on mental health status in SLE patients.Methods A total of 314 SLE patients were included, and divided into non GC group, low-dose GC group, and moderate to high doses GC group. The mental health status in these patients were measured by Symptom Checklist 90(SCL-90), and the effect of glucocorticoid on mental health status of lupus patients were analyzed.Results Among the 314 patients,141(44.9%) received low dose of hormone,and the average dose of hormone in each groupwas 0 mg,(4.1±2.2)mg and(15.1±9.1)mg,In the moderate to high doses GC group, the scores of other items(depression, anxiety, hostility, horror, psychotic, sleep) were higher than the other groups(P<0.05), the total score of SCL-90 and the scores of other items(depression, anxiety, hostility, horror, psychotic) were higher than those of the norm in 2006(P<0.003 or P<0.001).Conclusion There are some mental health problems in SLE patients, glucocorticoid dose is the most important influencing factor, and low-dose glucocorticoid is relatively safe.