心力衰竭患者躯体化症状及其影响因素

The status somatization symptoms and its influencing factors of in patients with heart failure

目的分析心力衰竭患者出现躯体化症状的现状及其影响因素。方法采用便利抽样法,选取2023年8月~10月就诊于济宁医学院附属医院心内科病房的心力衰竭住院患者为研究对象。患者均接受躯体化症状自评量表(Somatic Self-rating Scale,SSS)评估躯体化症状,<36分代表无躯体化症状,≥36分代表有躯体化症状,将发生躯体化症状患者纳入有躯体化症状组,将未发生躯体化症状患者纳入无躯体化症状组。统计患者基线资料,采用二元Logistic回归分析心力衰竭患者发生躯体化症状的影响因素。结果219例心衰患者中存在躯体化症状117(53.42%)例,躯体化症状患者健康问卷抑郁症状群量表(Patient health questionnaire,PHQ-9),广泛性焦虑量表(Generalized anxiety disorder-7,GAD-7)评分分别为(7.83±5.07)分,(5.58±4.124)分;心衰患者有无躯体化症状在文化程度,人均收入,家庭关系,射血分数(EF)值,心功能分级,自理能力分级,应用抗焦虑药物,PHQ-9,GAD-7方面比较差异有统计学意义(P<0.05);二元logistics回归分析结果显示,人均收入≥5000元(OR=0.156,95%CI=0.034~0.703,P=0.016),自理能力为无需依赖(OR=0.240,95%CI=0.068~0.847,P=0.027)及轻度依赖者(OR=0.265,95%CI=0.082~0.859,P=0.027),文化程度为高中及以上(OR=0.280,95%CI=0.127~0.62,P=0.002)是心力衰竭患者发生躯体化症状的保护因素(OR<1,P<0.05);家庭关系一般(OR=3.069,95%CI=1.081~8.717,P=0.035),焦虑(OR=2.599,95%CI=1.108~6.094,P=0.028),抑郁(OR=2.518,95%CI=1.01~6.278,P=0.047)是心力衰竭患者发生躯体化症状的危险因素(OR>1,P<0.05)。结论心力衰竭患者躯体化症状发生率较高,人均收入,自理能力,文化程度,家庭关系,焦虑,抑郁是心力衰竭患者发生躯体化症状的独立影响因素。

Objective To study the current situation of somatization symptoms in patients with heart failure and its influencing factors.Methods Using the convenience sampling method,the heart failure hospitalized patients who visited the cardiology ward of the Affiliated Hospital of Jining Medical University from August to October 2023 were selected as the study subjects.All patients were assessed with the somatic symptom self-rating scale(SSS).<36 points indicated no somatic symptoms,and≥36 points indicated somatic symptoms.Patients with somatic symptoms were included in the group with somatic symptoms,and patients without somatic symptoms were included in the group without somatic symptoms.The baseline data of patients were collected,and the influencing factors of somatization symptoms in patients with heart failure were analyzed by binary Logistic regression.Results There were 117(53.42%)patients with somatization symptoms in 219 patients with heart failure.The scores of PHQ-9 and GAD-7 were(7.83±5.07)and(5.58±4.124)respectively.There were significant differences in education level,per capita income,family relationship,EF value,cardiac function classification,self-care ability classification,application of anti-anxiety drugs,PHQ-9 and GAD-7 between patients with and without somatization symptoms in patients with heart failure(P<0.05).The results of binary logistics regression analysis showed.Per capita income≥5000 yuan(OR=0.156,95%CI=0.034-0.703,P=0.016),self-care ability without dependence(OR=0.240,95%CI=0.068-0.847,P=0.027)and mild dependence(OR=0.265,95%CI=0.082-0.859,P=0.027),high school education or above(OR=0.280,95%CI=0.127-0.62,P=0.002)were protective factors for somatization symptoms in patients with heart failure(OR<1,P<0.05).General family relationship(OR=3.069,95%CI=1.081-8.717,P=0.035),anxiety(OR=2.599,95%CI=1.108-6.094,P=0.028)and depression(OR=2.518,95%CI=1.01-6.278,P=0.047)were risk factors for somatization symptoms in patients with heart failure(OR>1,P<0.05).Conclusion The incidence of somatization symptoms in patients with heart failure is high.Per capita income,self-care ability,education level,family relationship,anxiety and depression are independent influencing factors of somatization symptoms in patients with heart failure.