冠心病患者躯体化症状焦虑和抑郁及其影响因素

Somatization symptoms,anxiety,depression and its influencing factors in patients with coronary heart disease

目的探讨冠心病患者躯体症状、焦虑、抑郁及其影响因素。方法对500例冠心病患者采用躯体化症状自评量表、抑郁症筛查量表、广泛性焦虑自评量表评估患者躯体化症状、抑郁、焦虑症状,并分析躯体化症状与抑郁、焦虑的相关性;采用多元Logistic回归模型探讨其影响因素。结果500例冠心病患者存在躯体化症状80例(16.00%),躯体化症状越严重,抑郁症筛查量表、广泛性焦虑自评量表评分越高(P<0.01)。Pearson相关分析显示,有躯体化症状冠心病患者躯体化症状自评量表评分与抑郁症筛查量表、广泛性焦虑自评量表评分存在显著正相关(P<0.01)。单因素分析显示,有无躯体化症状冠心病患者在性别、年龄、吸烟史、高血压、焦虑以及抑郁方面比较有显著性差异(P<0.05)。多元Logistic回归分析结果显示:性别、年龄、吸烟、焦虑、抑郁与冠心病躯体化症状相关联(P<0.01)。结论冠心病患者躯体症状以非特异性全身不适症状为主,且与抑郁、焦虑存在明显相关性。冠心病躯体症状影响因素包括性别、年龄、吸烟史、焦虑以及抑郁等,应对其予以有针对性的干预,改善其健康状况。

Objective To explore somatic symptoms,anxiety,depression and its influencing factors in patients with coronary heart disease(CHD).Methods A total of 500 CHD patients were studied.Somatic,depressive and anxious symptoms of all patients were assessed with the Somatic Symptom Self-rating Scale(SSS),Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder(GAD-7)respectively,correlations of somatic symptoms with depressive and anxious symptoms analyzed;multivariate logistic regression model was used to explore the influencing factors.Results Of 500 CHD patients 80 had somatic symptoms(16.00%),the severer somatic symptoms,the higher scores on PHQ-9 and GAD(P<0.01).Pearson correlation analysis showed that the SSS score was positively correlated with PHQ-9 and GAD-7 score significantly(P<0.01).Univariate analysis showed that there were significant differences in sex,age,smoking history,hypertension,anxiety and depression between CHD patients with and without somatic symptoms(P<0.05).Multivariate logistic regression regression results showed that age,smoking,anxiety and depression were associated with somatic symptoms of the CHD(P<0.01).Conclusion The main somatic symptoms of CHD patients are non-specific symptoms of general malaise and obviously related to depression and anxiety.Factors influencing somatic symptoms of CHD patients include gender,age,smoking history,anxiety,depression and so on,targeted intervention should be given to them in order to improve their healthy status.