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目的研究视神经脊髓炎(NMO)患者焦虑、抑郁现状及其与临床特点的相关性。方法对符合标准的NMO患者使用汉密尔顿焦虑量表-14(HARS-14)、汉密尔顿抑郁量表-21(HDRS-21)和扩展残疾状况量表(EDSS)进行评分,并分析焦虑、抑郁障碍与临床特点的关系。结果 65例NMO患者(5例男性,60例女性),平均年龄(39.85±10.36)岁,EDSS评分中位数为2.5分,躯体疼痛平均得分为(37.37±20.44)分,血清NMO-IgG阳性比例76.9%。焦虑评分结果平均值为(11.03±6.95)分,抑郁评分结果平均值为(11.74±7.78)分。65例患者中,有焦虑患者占27.69%(18/65),有抑郁患者占24.62(16/65)。单因素分析显示,EDSS评分与焦虑评分(r=0.285,P=0.004)、抑郁评分(r=0.328,P=0.008)呈低度正相关,躯体疼痛与焦虑评分(r=-0.561,P<0.001)、抑郁评分(r=-0.496,P<0.001)呈中度负相关,复发次数与焦虑评分(r=0.285,P=0.022)呈低度正相关。年龄、性别、病程、NMO-IgG对患者焦虑、抑郁均无影响。Logistic回归分析显示,躯体疼痛是NMO患者焦虑、抑郁的主要危险因素(比值比分别为1.052、1.046,P<0.05)。结论 NMO患者残疾状态与焦虑、抑郁均相关,发作次数与焦虑相关,躯体疼痛是NMO患者焦虑、抑郁的主要危险因素。
Objective To investigate the status of anxiety and depression in optic neuromyelitis patients (NMO) and its correlation with clinical features. Methods Patients with NMO who met the criteria were scored using the Hamilton Anxiety Scale-14 (HARS-14), Hamilton Depression Inventory-21 (HDRS-21) and Extended Disability Status Scale (EDSS), and were analyzed for anxiety, depression and Clinical characteristics of the relationship. Results The average age (39.85 ± 10.36) years, 65 patients with NMO (5 males and 60 females) had a median EDSS score of 2.5 and a mean body pain score of (37.37 ± 20.44), positive serum NMO-IgG The ratio of 76.9%. The mean value of anxiety score was (11.03 ± 6.95) and the average value of depression score was (11.74 ± 7.78). Among the 65 patients, there were 27.69% (18/65) with anxiety and 24.62 (16/65) with depression. Univariate analysis showed that there was a low positive correlation between EDSS score and anxiety score (r = 0.285, P = 0.004), depression score (r = 0.328, P = 0.008), somatic pain and anxiety score (r = -0.561, 0.001) and depression (r = -0.496, P <0.001). There was a low positive correlation between the number of relapse and anxiety score (r = 0.285, P = 0.022) Age, sex, course of disease, NMO-IgG had no effect on anxiety and depression in patients. Logistic regression analysis showed that somatic pain was the main risk factor of anxiety and depression in NMO patients (odds ratio 1.052, 1.046, P <0.05 respectively). Conclusion The disability of NMO patients is related to anxiety and depression. The number of attacks is related to anxiety. Somatic pain is the main risk factor of anxiety and depression in NMO patients.