双相情感障碍首发躁狂患者治疗后残留症状情况及其影响因素分析

Posttreatment residual symptoms of patients with bipolar disorder starting with mania and influencing factors

目的探究双相情感障碍首发躁狂患者治疗后残留症状情况,并分析其影响因素。方法将100例双相情感障碍首发躁狂患者作为研究对象,对其进行统计学调查,使用汉密顿抑郁量表(HAMD)、32项轻躁狂症状清单(HCL-32)、汉密顿焦虑量表(HAMA)评估患者的残留情绪症状,使用匹兹堡睡眠质量指数(PSQI)评估患者的残留睡眠症状,将HAMD评分≥4分、HCL-32评分≥1分、HAMA评分≥7分、PSQI评分>5分(满足上述任一即可)的双相情感障碍首发躁狂患者纳入残留症状组,其余则纳入无残留症状组。比较两组患者的临床资料,采用Logistic回归分析探讨影响双相情感障碍首发躁狂患者残留症状的影响因素。结果入组的100例双相情感障碍首发躁狂患者中,存在残留症状患者40例,残留症状发生率为40%,其中残留情绪症状患者25例,残留睡眠症状患者15例。苯二氮?类药物使用、诊断延迟时间、服药依从性及睡眠障碍均为双相情感障碍首发躁狂患者治疗后残留症状的影响因素(P<0.05)。结论双相情感障碍首发躁狂患者治疗后残留症状的发生风险较高,与苯二氮?类药物使用、诊断延迟时间、服药依从性及睡眠障碍等因素有关,临床应尽早针对上述因素进行防范。

Objective To explore posttreatment residual symptoms of patients with bipolar disorder(BD)starting with manic phase and analyze their inf luencing factors.Methods A total of 100 patients with BD starting with manic phase were selected as research objects,statistical surveys performed,residual emotional symptoms assessed using Hamilton Depression Scale(HAMD),32-item Hypomania Checklist(HCL-32)and Hamilton An xiety Scale(HAM A),residual sleep symptoms done using the Pittsburgh Sleep Index Scale(PSQI),patients with HAMD score≥4,HCL-32 score≥1,HAMA score≥7and PSQI score>5(satisfying any of the above)included in residual symptom group,and the rest in the group without residual symptoms.The clinical data of the two groups were compared,Logistic regression analysis was used to explore the influencing factors of residual symptoms of patients with BD starting with manic phase.Results Of the 100 patients 40 ones had residual symptoms,the incidence of residual symptoms was 40%,including 25 ones with residual emotional symptoms and 15 residual sleep symptoms.Benzodiazepine use,delaying in diagnosis,medication compliance and sleep disturbance were all inf luencing factors of residual symptoms in patients with BD starting with mania(P<0.05).Conclusion The risk of posttreatment residual symptoms is higher in patients with BD starting with mania,which is related to benzodiazepine use,delayed diag nosis,medication compliance and sleep disorders,and clinical prevention should be carried out against the above factors as soon as possible.