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目的调查肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)患者心理健康状况及共病情绪障碍情况,为患者及时获得心理及药物治疗提供依据。方法选择2011年9月至2015年2月在我院诊治的ALS患者72例作为病例组,选择同期在我院进行体检的性别及年龄匹配的健康者72例作为对照组,收集两组患者一般情况,对两组进行心理学量表测评,调查其共病焦虑抑郁情况。结果 ALS组的汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和汉密尔顿抑郁量表-17项(Hamilton rating scale for depression,HRSD-17)评分分别为(41.22±1.45)分和(40.56±2.89)分,而对照组两个量表评分分别为(28.59±2.10)分和(24.20±3.14)分,ALS组明显高于对照组(P<0.05)。ALS患者共病睡眠障碍、焦虑障碍和抑郁障碍的比例分别为36.1%、33.3%和31.9%,均明显高于同年龄段对照组(分别为5.6%、4.2%和2.8%)。Pearson相关分析结果显示,修订版ALS功能评分量表(ALS functional ratingscale-revised,ALSFRS-R)与心理状况评分呈明显相关性(P<0.05);logistic回归分析显示病程、受教育程度、ALS-FRS-R评分为主要的影响因素(P<0.05)。结论 ALS患者合并严重的抑郁情绪问题,且抑郁情绪与患者疾病病程、受教育年限、病情直接相关,需要得到及时的干预。
Objective To investigate the mental health status and comorbidity mood disorders in patients with amyotrophic lateral sclerosis (ALS) and provide the basis for timely psychological and medical treatment. Methods Seventy-two patients with ALS who were diagnosed and treated in our hospital from September 2011 to February 2015 were selected as the case group, and 72 healthy and age-matched healthy subjects in our hospital during the same period were selected as the control group. Two groups of patients Situation, the two groups were psychology scale evaluation, investigation of its comorbidity anxiety and depression. Results The scores of Hamilton anxiety scale (HAMA) and Hamilton rating scale for depression (HRSD-17) in ALS group were (41.22 ± 1.45) and (40.56 ± 2.89) (28.59 ± 2.10) and (24.20 ± 3.14) points respectively in the control group, which was significantly higher in the ALS group than in the control group (P <0.05). The rates of comorbid sleep disorders, anxiety disorders and depression in patients with ALS were 36.1%, 33.3% and 31.9%, respectively, which were significantly higher than those in the same age group (5.6%, 4.2% and 2.8% respectively). Pearson correlation analysis showed that there was a significant correlation between ALSFRS-R and psychological status scores (P <0.05). Logistic regression analysis showed that the duration of disease, education level, ALS- FRS-R score as the main influencing factor (P <0.05). Conclusion ALS patients with severe depression problems, and depression and disease duration, education and illness are directly related to the need for timely intervention.