【摘要】：目的:研究慢性蕁麻疹患者焦慮、抑郁情緒,探討可能對其發(fā)生、發(fā)展產(chǎn)生影響的因素;為臨床識別易于發(fā)生焦慮、抑郁情緒的慢性蕁麻疹患者提供線索。觀察慢性蕁麻疹患者服藥依從性,探究焦慮、抑郁情緒對慢性蕁麻疹患者服藥依從性的影響,引起對慢性蕁麻疹患者焦慮、抑郁情緒的重視。研究方法:收集江蘇大學附屬醫(yī)院2015年2月至2016年12月間門診就診的慢性蕁麻疹患者。按照一般就診流程采集相關(guān)病史信息,行必要的實驗室檢查,包括自體血清皮膚試驗及變應原檢測試驗等。按照納入排除標準篩選患者,經(jīng)知情同意后納入調(diào)查,記錄一般情況及相關(guān)臨床信息,在調(diào)查人員指導下由患者獨立填寫《蕁麻疹活動性評分》評估疾病活動性,由患者獨立完成《綜合性醫(yī)院焦慮、抑郁量表》評估焦慮、抑郁情緒。兩周后對接受標準治療的慢性蕁麻疹患者進行回訪,以《Morisky服藥依從性問卷》評估服藥依從性。調(diào)查結(jié)束后應用Excel 17.0軟件整理所有數(shù)據(jù)并建立數(shù)據(jù)庫、SPSS 22.0統(tǒng)計軟件統(tǒng)計分析《綜合性醫(yī)院焦慮、抑郁量表》得分,描述慢性蕁麻疹患者焦慮、抑郁情緒的發(fā)生概況,并將其與中國常模對比;根據(jù)一般情況及相關(guān)臨床信息、實驗室檢查結(jié)果將患者分組,分析焦慮、抑郁的相關(guān)因子;比較檢出焦慮、抑郁情緒的慢性蕁麻疹患者與未檢出者在服藥依從性上有無差異。相應的數(shù)據(jù)比較分析行t檢驗、卡方檢驗、秩和檢驗、二元logistic回歸分析等,以P㩳0.05視為存在顯著統(tǒng)計學意義。結(jié)果:研究共納入138例慢性蕁麻疹患者,與常模對比慢性蕁麻疹患者焦慮、抑郁情緒水平均高,且存在顯著統(tǒng)計學差異(p㩳0.05)。單因素分析顯示:性別、年齡、婚姻、生育情況、教育程度、病程、生活事件、血管性水腫與焦慮情緒相關(guān),存在統(tǒng)計學意義(p㩳0.05),二元logistics回歸分析顯示性別、病程、血管性水腫是獨立的危險因素;性別、年齡、生育情況、生活事件、血管性水腫與抑郁情緒相關(guān),且有統(tǒng)計學意義(p㩳0.05),二元logistics回歸分析顯示性別、血管性水腫是獨立的危險因素。受調(diào)查的慢性蕁麻疹患者整體服藥依從性不理想,存在焦慮、抑郁情緒的慢性蕁麻疹患者服藥依從性與未檢出者相比《Morisky服藥依從性問卷》評分及評級均差,且差異有顯著統(tǒng)計學意義(p㩳0.05)。結(jié)論:女性、青年、近1年內(nèi)經(jīng)歷生活事件、有血管性水腫癥狀是焦慮、抑郁情緒共同的高危因素。此外,未婚、未生育、高等教育背景、病程1年內(nèi)是焦慮情緒的危險因素,而已生育則是抑郁情緒的高危因素。在臨床工作中以上群體的慢性蕁麻疹患者應當格外注意發(fā)生焦慮、抑郁情緒的可能,推薦使用《綜合性醫(yī)院焦慮、抑郁量表》對其進行進行焦慮、抑郁情緒的篩查。慢性蕁麻疹患者的服藥依從性尚不理想,因焦慮、抑郁情緒顯著降低患者服藥依從性,需要注重對伴有焦慮、抑郁者的服藥督促,防治因不依從造成的療效不理想。
[Abstract]:Objective: to study anxiety and depression in patients with chronic urticaria and to explore the factors that may affect their occurrence and development, and to provide clues for clinical identification of patients with chronic urticaria who are prone to anxiety and depression. To observe the drug compliance of patients with chronic urticaria and explore the influence of anxiety and depression on the compliance of patients with chronic urticaria, and to pay attention to the anxiety and depression of patients with chronic urticaria. Methods: patients with chronic urticaria from February 2015 to December 2016 were collected from affiliated Hospital of Jiangsu University. Collect the relevant medical history according to the general procedure, carry out necessary laboratory examination, including autologous serum skin test and allergen test, etc. According to the exclusion criteria, the patients were screened and investigated after informed consent, and the general information and related clinical information were recorded. Under the guidance of the investigators, the patients independently filled out the "Urticaria activity score" and evaluated the disease activity. The anxiety and depression were evaluated by the comprehensive hospital anxiety and depression scale. Two weeks later, patients with chronic urticaria who received standard treatment were interviewed and evaluated with the < Morisky compliance questionnaire >. After the investigation, all the data were sorted out by using Excel 17.0 software and a database was established. The statistical analysis software < General Hospital anxiety and Depression scale > was used to describe the occurrence of anxiety and depression in patients with chronic urticaria. According to the general situation and related clinical information, the patients were divided into groups and analyzed the related factors of anxiety and depression. There was no difference in drug compliance between chronic urticaria patients with depression and undetected urticaria patients. The corresponding data were compared and analyzed with t test, chi-square test, rank sum test and binary logistic regression analysis. Results: 138 patients with chronic urticaria were enrolled in the study. Compared with the norm, the anxiety and depression levels of the patients with chronic urticaria were significantly higher than those of the control group (p0.05). Univariate analysis showed that sex, age, marriage, fertility, education level, course of disease, life events, vascular edema and anxiety were significantly correlated (p0. 05). Binary logistics regression analysis showed gender, course of disease. Vascular edema was an independent risk factor, sex, age, fertility, life events and vascular edema were significantly correlated with depression (p0. 05). Binary logistics regression analysis showed that Vascular edema was an independent risk factor. The overall compliance of patients with chronic urticaria was not satisfactory, anxiety, depression in patients with chronic urticaria patients with drug compliance than those without detection of the < Morisky compliance questionnaire > score and rating mean difference. The difference was statistically significant (p0.05). Conclusion: women, young people, experienced life events within one year, vascular edema symptoms are the common high risk factors of anxiety and depression. In addition, unmarried, childless, higher education background, course of disease within one year are the risk factors of anxiety, but fertility is the high risk factor of depression. In clinical work, the patients with chronic urticaria in the above groups should pay special attention to the possibility of anxiety and depression. It is recommended to use the General Hospital anxiety and Depression scale to screen them for anxiety and depression. The drug compliance of patients with chronic urticaria is not ideal, because of anxiety, depression significantly reduce the patients' compliance, need to pay attention to the patients with anxiety, depression drug supervision, prevention and treatment of non-compliance caused by the efficacy is not ideal.
【學位授予單位】：江蘇大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.24

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