吉兰-巴雷综合征病后抑郁特点及其影响因素研究

Study on the characteristics and influencing factors of post Guillain-Barre syndrome depression

目的研究吉兰-巴雷综合征(GBS)病后抑郁的特点及其影响因素,为GBS病后抑郁的干预提供依据。方法回顾性分析60例GBS患者的临床资料,采用抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)对患者的抑郁症状进行评定,观察GBS病后抑郁的发生情况、GBS病后抑郁患者的临床症状,分析GBS病后抑郁的影响因素。结果 60例GBS患者中, 38例SDS评分<30分的非抑郁患者,占比63.33%;22例SDS评分≥30分的抑郁患者,占比36.67%;22例GBS病后抑郁患者中, 15例轻度抑郁(HAMD评分≥7分且<16分),占比68.18%;7例中-重度抑郁(HAMD评分≥16分),占比31.82%。22例GBS病后抑郁患者中肢体活动障碍20例(90.91%)、感觉异常16例(72.73%)。抑郁患者性别、脑血管病史、抑郁症史、住院、运动障碍、感觉障碍、负性生活事件、家庭不睦、未就业、经济困难、丧偶情况与非抑郁患者比较差异具有统计学意义(P<0.05)。因变量为有无抑郁,自变量为住院、性别、经济困难、家庭不睦、未就业、丧偶、脑血管病史、抑郁症病史、负性生活事件、运动障碍、感觉障碍、丧偶,进行多元回归分析,结果显示:GBS病后抑郁并非单因素作用的结果;经Logistic多元回归分析逐级剔除,住院、运动障碍、感觉障碍是GBS病后抑郁的影响因素(P<0.05)。结论 GBS病后抑郁发生率较高,其主要特点为睡眠障碍、焦虑/躯体化障碍,是多种原因共同作用的结果。

Objective To study the characteristics and influencing factors of post Guillain-Barre syndrome(GBS)depression,so as to provide basis for post Guillain-Barre syndrome depression intervention.Methods The clinical data of 60 patients with GBS were retrospectively analyzed.Self-rating depression scale(SDS)and Hamilton depression scale(HAMD)were used to evaluate the depressive symptoms of the patients.The incidence of post GBS depression and clinical symptoms of patients with post GBS depression were observed,and the influencing factors of post GBS depression were analyzed.Results Among the 60 GBS patients,38 non-depressed patients with an SDS score<30 points,accounting for 63.33%;22 depressed patients with an SDS score≥30 points,accounting for 36.67%;among 22 patients with post-GBS depression,15 cases had mild depression(HAMD score≥7 points and<16 points),accounting for 68.18%,7 cases had moderate to severe depression(HAMD score≥16 points),accounting for 31.82%.Among the 22 patients with post-GBS depression,20 cases(90.91%)had limb dysfunction and 16 cases(72.73%)had paresthesia.The gender,history of cerebrovascular disease,history of depression,hospitalization,dyskinesia,sensory disturbance,negative life events,family disharmony,unemployed,financial difficulties,widowhood of depression patients had statistically significant difference compared with non-depression patients(P<0.05).Taking depression as the dependent variable,hospitalization,gender,financial difficulties,family disharmony,unemployed,widowed,history of cerebrovascular disease,history of depression,negative life events,dyskinesia,sensory disturbance,and widowhood as independent variables for multiple regression analysis,,and the results show that depression after GBS disease was not the result of a single factor;logistic multiple regression analysis showed that hospitalization,dyskinesia,and sensory disturbance were the influencing factors of depression after GBS disease(P<0.05).Conclusion The occurrence of post Guillain-Barre syndrome depression is high,and its main characteristics are sleep disorders and anxiety/somatization disorders,which are the results of a combination of multiple reasons.