不同食管症状患者在新型冠状病毒流行期间的心理健康状况分析

Mental health status of patients with esophageal symptoms and esophageal motility disorders during coronavirus pandemic

目的:研究新型冠状病毒(新冠)疫情期间不同食管症状和(或)食管动力障碍患者的心理健康状况及相关因素。方法:回顾性分析2020年4月至2021年12月在我院接受高分辨率食管测压(high-resolution manometry,HRM)的137例具有不同食管症状且新冠核酸阴性的患者数据,包括人口学特征、食管症状、HRM结果、9项患者健康问卷(9-item patient health questionnaire,PHQ-9)及广泛性焦虑症(generalized anxiety disorder,GAD-7)评估量表评分及出现心理异常的相关因素。结果:接受HRM检查的137例患者中,62.0%有抑郁障碍和59.9%有焦虑障碍。大多数(71.1%)有反流症状的患者会出现焦虑障碍(P=0.045)。然而,胸痛患者的GAD-7评分[18.00(10.00~20.00)分]高于其他食管症状的患者(P=0.049)。无食管动力障碍组GAD-7评分[15.00(7.50~18.50)分]显著高于有食管动力障碍组[9.00(6.00~13.00)分](P=0.012)。中度抑郁组(P=0.034)和重度焦虑组(P=0.008)中低体质量指数(body mass index,BMI)患者较多。在重度焦虑组中反流症状患者更多(P=0.035),而轻度焦虑组贲门失弛缓患者更多(P=0.009)。年龄<40岁[优势比(odds ratio,OR)=15.02,95%置信区间(confidence interval,CI):2.50~90.30]、BMI<18 kg/m2(OR=9.37,95%CI:1.11~79.46)、癔球症(OR=5.89,95%CI:1.09~31.75)、反流(OR=5.57,95%CI:1.12~27.64)]和贲门失弛缓(OR=15.72,95%CI:2.82~87.71)是这类患者焦虑障碍的危险因素,而单身(OR=0.03,95%CI:0.00~0.61)是患者焦虑障碍的保护因素。结论:在新冠流行期间,心理异常在具有食管症状和(或)食管动力障碍的患者中较为普遍。年轻、低BMI、癔球症、反流和贲门失弛缓都是这类患者在疫情期间出现焦虑障碍的危险因素,而单身似乎是焦虑障碍的保护因素。

Objective To investigate the mental health status of the patients with different esophageal symptoms and/or esophageal motility disorders during the coronavirus pandemic.Methods The data of 137 coronavirus-negative patients with different esophageal symptoms,who underwent high-resolution manometry(HRM)from April in 2020 to December in 2021 were retrospectively analyzed.The demographic characteristics,esophageal symptoms,HRM results,scores of 9-item patient health questionnaire(PHQ-9)and scores of 7-item generalized anxiety disorder(GAD-7)scale and the risk factors for psychological disorders were analyzed.Results In 137 patients who underwent HRM,62.0%(85/137)cases had depression,and 59.9%(82/137)cases had anxiety.Most of the patients(97/137)with regurgitation presented anxiety(71.1%,P=0.045).However,the GAD-7 score in the patients with chest pain[18.00(10.00-20.00)]was higher than that in the patients with other symptoms(P=0.049).The GAD-7 score[15.00(7.50-18.50)]in the patients without esophageal motility disorder was higher than that[9.00(6.00-13.00)]in the patients with esophageal motility disorder(P=0.012).A lower body mass index(BMI)was discovered in the moderate depression group(P=0.034)and in the severe anxiety group(P=0.008).There were more patients with regurgitation in severe anxiety group(P=0.035),while the mild anxiety group contained more patients with achalasia(P=0.009).Age<40 years[odds ratio(OR)=15.02,95%confidence interval(CI):2.50-90.30],BMI<18 kg/m2(OR=9.37,95%CI:1.11-79.46),globus(OR=5.89,95%CI:1.09-31.75),regurgitation(OR=5.57,95%CI:1.12-27.64)and achalasia(OR=15.72,95%CI:2.82-87.71)were risk factors for anxiety,while single(OR=0.03,95%CI:0.00-0.61)was protective factors for anxiety.Conclusions Psychological disorders are common in the patients with esophageal symptoms and esophageal motility disorders during the coronavirus pandemic.Young age,low BMI,globus,regurgitation and achalasia are risk factors for anxiety,while single is protective factors of anxiety.