老年胃溃疡患者临床特征、负面情绪及生活质量研究

Clinical characteristics,negative emotions and quality of life in elderly patients with gastric ulcer

目的探讨胃溃疡患者与健康志愿者的负面情绪及生活质量差异,并对比老年与中青年胃溃疡患者的临床特征,分析影响各年龄段胃溃疡患者生活质量的相关因素。方法将2020年1月至2022年1月琼海市中医院综合内科收治的315例胃溃疡患者纳为观察组,同时将健康体检部接收的180名健康体检者纳为健康对照组。根据年龄,将观察组中33~59岁患者分为中青年组(n=163),≥60岁患者分为老年组(n=152)。采用简明健康问卷(SF-36)以及医院焦虑及抑郁量表(HADS)评估研究对象的生活质量及焦虑、抑郁情绪。分析老年及中青年慢性胃溃疡患者的临床特征。采用SPSS 22.0统计软件进行数据分析。采用多元线性回归模型分析影响老年及中青年胃溃疡患者生活质量的相关因素。结果观察组患者SF-36中躯体功能、躯体疼痛、一般健康情况、社会功能、情绪职能、精神健康领域得分以及总得分均低于健康对照组,焦虑以及抑郁得分,焦虑、抑郁以及焦虑合并抑郁检出率均高于健康对照组,差异均有统计学意义(均P<0.05)。老年胃溃疡患者SF-36中躯体疼痛、情绪职能、精神健康领域得分以及总得分均高于中青年胃溃疡患者,焦虑以及抑郁得分,焦虑、抑郁以及焦虑合并抑郁检出率均低于中青年组,差异均有统计学意义(均P<0.05)。与中青年胃溃疡患者相比,老年胃溃疡患者合并基础性疾病者比例更高,出现腹痛症状者比例更低,呕血或黑便、贫血或乏力以及不典型症状者比例更高,幽门螺旋杆菌阳性以及并发消化道出血者比例更高,差异均有统计学意义(P<0.05)。多元线性回归分析提示,社会生活事件超负荷量(β=-0.135,P<0.001)及焦虑(β=-0.213,P<0.001)是影响中青年胃溃疡患者生活质量的相关因素;家庭月收入(β=0.175,P<0.001)及胃溃疡相关并发症(β=-0.278,P<0.001)是影响老年胃溃疡患者生活质量的相关因素。结论胃溃疡患者生活质量明显低于健康人群,焦虑、抑郁检出率更高。与中青年患者相比,疾病对老年胃溃疡患者躯体疼痛、情绪职能及精神健康所造成的影响更小,老年胃溃疡患者焦虑、抑郁检出率更低,但不同年龄段胃溃疡患者整体生活质量差异不大,且不同年龄段胃溃疡患者生活质量的影响因素也不同。

Objective To explore the differences in negative emotions and quality of life between gastric ulcer patients and healthy volunteers,compare the clinical characteristics of elderly patients and young and middle-aged patients with gastric ulcer,and analyze the factors affecting the quality of life of gastric ulcer patients in different age groups.Methods A total of 315 patients with gastric ulcers admitted to the Department of General Medicine of Qionghai Traditional Chinese Medicine Hospital from January 2020 to January 2022 were included in the observation group,and 180 healthy examinees at the Health Examination Department were included in the healthy control group.According to age,the patients in the observation group were divided into the young and middle-aged group(aged 33-59 years;n=163)and the elderly group(aged≥60 years;n=152).The short-form-36 health survey(SF-36)and hospital anxiety and depression scale(HADS)were used to evaluate the quality of life and emotions of anxiety and depression in the subjects.The clinical characteristics were analyzed in the young,middle-aged and elderly patients with chronic gastric ulcers.SPSS 22.0 was used for data analysis.A multiple linear regression model was employed to analyze the factors affecting the quality of life of the young,middle-aged and elderly patients with gastric ulcer.Results The scores for physical function,body pain,general health,social function,emotional funciton,mental health,and total score on SF-36 scale in the observation group were lower than those in the healthy control group;the scores for anxiety and depression,and the detection rates of anxiety,depression and anxiety coupled with depression were higher than those in the healthy control group;and the differences were statistically significant(P<0.05).The scores for body pain,emotional function,mental health,and total score on SF-36 scale in the elderly group were higher than those in the young and middle-aged group;the scores for anxiety and depression,and the detection rates of anxiety,depression and anxiety coupled with depression were lower than those in the young and middle-aged group;the differences were statistically significant(P<0.05).Compared with the young and middle-aged group,the proportion of patients with concurrent underlying disease in the elderly group was higher;the proportion of patients with abdominal pain was lower;the proportions of patients with hematemesis or melena,anemia/fatigue,atypical symptom helicobacter pylori infection and gastrointestinal bleeding were higher;the differences were statistically significant(P<0.05).Multivariate linear regression analysis indicated that the social life event over load(β=-0.135,P<0.001)and anxiety(β=-0.213,P<0.001)were factors affecting the quality of life in the young and middle-aged patients with gastric ulcer,and that the family monthly income(β=0.175,P<0.001)and gastric ulcer-related complication(β=-0.278,P<0.001)were factors affecting the quality of life in the elderly patients with gastric ulcer.Conclusion The quality of life in patients with gastric ulcer is significantly lower than that in healthy people,and the detection rates of anxiety and depression are higher.Compared with young and middle-aged patients,the disease has less impact on body pain,emotional function of elderly patients with gastric ulcer,and the detection rates of anxiety and depression are lower in elderly patients with gastric ulcer,but the overall quality of life of patients with gastric ulcer in different age groups does not differ significantly.The influencing factors of quality of life in patients with gastric ulcer in different age groups are also different.