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背景慢性乙肝(Chronic Hepatitis B,CHB)和乙肝后肝硬化(Hepatitis B Cirrhosis,HBC)患者经常伴发抑郁、焦虑症状,但病程进展中的心理状况和CHB、HBC患者的病情之间的关系尚不清楚。目的对住院治疗的CHB和HBC急性发作患者的抑郁和焦虑症状的变化进行评估。方法对71例CHB和75例HBC患者在入院治疗时进行测评,其后治疗期间随访8周。同时,以健康志愿者65人作对照组。分别对3组对象在入院时和随访第8周时进行90项症状自评量表(Symptom Check List-90,SCL-90)测评。采用汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)及抑郁自评量表(Self-Rating Depression Scale,SDS)分别对3组研究对象每隔2周,即入院时、随访第2周、第4周、第6周、第8周时进行评定。结果每组均有60例对象完成测评。CHB组和HBC组的基线SCL-90总均分、大部分SCL-90因子分、HAMA、HAMD、SAS及SDS评分的均分均高于健康对照组。HAMA、HAMD评定显示,在入院时40%的CHB和80%的HBC患者有明显焦虑症状,78%的CHB和87%的HBC患者有明显的抑郁。治疗8周后,两组患者的SCL-90总均分、大部分SCL-90因子分均显著下降。治疗6周后,两组患者的HAMA、HAMD、SAS及SDS评分的均分也显著下降。治疗8周后,5%的CHB和28%的HBC患者仍有明显焦虑,7%的CHB和36%的HBC患者有明显抑郁。基线和4次测评分均提示,HBC组比CHB组患者的心理症状严重。结论在CHB、HBC患者急性发作入院时和经临床治疗急性症状缓解后,两组患者自评、他评的心理症状均比健康对照组严重。HBC组比CHB组患者的心理症状更严重。对急性发作的CHB、HBC患者的躯体症状治疗8周后,其心理症状也可改善,但并不能完全消除。
Background Chronic Hepatitis B (CHB) and Hepatitis B Cirrhosis (HBC) patients often experience depression and anxiety symptoms, but the relationship between the psychological status of the course of disease and the CHB and HBC patients Not clear. Objective To assess the changes of depression and anxiety symptoms in hospitalized patients with CHB and HBC exacerbations. Methods Totally 71 CHB patients and 75 HBC patients were evaluated during admission and were followed up for 8 weeks. At the same time, 65 healthy volunteers as control group. 90 Symptom Check List-90 (SCL-90) tests were performed on 3 groups of subjects at admission and at the 8th week of follow-up. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale, SDS) were evaluated every three weeks in the three groups, that is, on admission, at the second week, the fourth week, the sixth week and the eighth week after the visit. Results Each group of 60 subjects completed the evaluation. Baseline SCL-90 total scores, CHL scores and HBC scores were higher than those in healthy controls. Most of the scores of SCL-90, HAMA, HAMD, SAS and SDS were higher than those of controls. HAMA, HAMD assessment showed significant anxiety symptoms in 40% of CHB and 80% of HBC patients on admission, and significant depression in 78% of CHB and 87% of HBC patients. After 8 weeks of treatment, the total score of SCL-90 and the majority of SCL-90 scores decreased significantly in both groups. After 6 weeks of treatment, the mean scores for HAMA, HAMD, SAS, and SDS scores were also significantly decreased in both groups. After 8 weeks of treatment, 5% of CHB and 28% of HBC patients were still significantly anxious, 7% of CHB and 36% of HBC patients were significantly depressed. Baseline and 4 test scores all suggest that HBC group than CHB patients with severe psychological symptoms. Conclusions After acute exacerbation of CHB and HBC patients and their clinical symptoms were relieved, their psychological symptoms were worse than those of healthy controls. Psychological symptoms were more severe in HBC patients than in CHB patients. In acute episodes of CHB, HBC patients with somatic symptoms after 8 weeks of treatment, the psychological symptoms can be improved, but not completely eliminated.