急性期治疗后抑郁症患者残留症状的危险因素分析

Risk Factors of Residual Symptoms in Patients with Depression After Acute Treatment

目的观察急性期治疗后抑郁症患者残留症状的危险因素。方法选择2019年6月-2021年3月中山市小榄人民医院收治的抑郁症患者作为分析对象,收集患者一般资料、席汉残疾量表(SDS)评分、15项患者健康问卷(PHQ-15)评分、世界卫生组织生存质量测定简表(WHOQOL-BREF)评分、急性期治疗药物分类、血清C反应蛋白(CRP)、淋巴细胞计数(LYM)、中性粒细胞计数(NEU)、中性粒细胞与淋巴细胞比值(NLR)。抑郁症状快速评定量表(QIDs)评估被纳入研究者残留症状的发生情况,Logistic回归分析急性期治疗后抑郁症患者残留症状发生的危险因素。结果单因素分析显示,性别、饮酒史、工作状态、病程、近2年复发次数、首次发病时精神症状、SDS评分、PHQ-15评分、WHOQOL-BREF评分、急性期治疗药物分类、CRP、LYM、NEU、NLR是抑郁症患者急性期治疗后残留症状发生的影响因素(P<0.05);二元Logistic回归分析显示,男性、近2年发作次数、SDS评分、合并镇静催眠药、合并抗精神病药和NLR水平是抑郁症患者急性期治疗后残留症状的危险因素(P<0.05)。结论抑郁症患者急性期治疗后残留症状的发生受多种因素的影响,临床应对男性、近2年发作次数、SDS评分、合并镇静催眠药、合并抗精神病药和NLR水平给予高度重视,及时予以药物和心理干预,降低残留症状的发生,促进患者康复。

Objective To observe the risk factors of residual symptoms in patients with depression after acute treatment.Methods Selected patients with depression admitted to Xiaolan People’s Hospital in Zhongshan City from June 2019 to March 2021 as the analysis object.The general information of patients,Sheehan Disability Scale(SDS)score,Patient Health Questionnaire-15(PHQ-15)score,World Health Organization Quality of Life-brief Version(WHOQOL-BREF)Score,classification of acute treatment drugs,serum C-reactive protein(CRP),lymphocyte count(LYM),neutrophils(NEU),neutrophil to lymphocyte ratio(NLR)were collected.The Quick Inventory of Depressive Symptomatology(QIDs)was used to evaluate the occurrence of residual symptoms among included researchers.Logistic regression analysis was used to analyze the risk factors of residual symptoms in patients with depression after acute treatment.Results Univariate analysis showed that gender,drinking history,work status,course of disease,number of relapses in the past 2 years,mental symptoms at the first onset,SDS score,PHQ-15 score,WHOQOL-BREF score,acute treatment drug classification,CRP,LYM,NEU and NLR were the influencing factors of residual symptoms after acute treatment in patients with depression(P<0.05).Binary Logistic regression analysis showed that males,number of episodes in the past 2 years,SDS score,combined sedatives and hypnotics,combined antipsychotics and NLR levels were risk factors for residual symptoms in patients with depression after acute treatment(P<0.05).Conclusion The occurrence of residual symptoms in patients with depression after acute treatment is affected by many factors.Clinical attention should be paid to male,frequency of attacks in recent 2 years,SDS score,combination of sedative and hypnotic drugs,combination of antipsychotic drugs and NLR levels,and timely drug and psychological intervention should be given to reduce the occurrence of residual symptoms and promote the rehabilitation of patients.