双相情感障碍触发因素【慢性肾功能不全患者情感障碍的现状及其影响因素的Logistic回归分析】

　　[摘要] 目的 对慢性肾功能不全患者及正常人情感进行全面评估，以了解患者情感状况。 方法 慢性肾功能不全患者48例设为观察组，另选择41例门诊体检健康者为对照组，两组共89例均进行SAS、SDS及SCL-90量表测量，采用单因素及多因素非条件Logistic回归方法分析影响肾功能不全患者情感状况的相关因素。 结果 观察组患者焦虑、抑郁评分及发生率明显高于对照组（P < 0.01）；观察组SCL-90量表躯体化、人际、抑郁、焦虑、恐怖、偏执项目评分均与对照组比较差异有高度统计学意义（P < 0.01）；多因素Logistic分析结果显示，全身并发症（OR = 1.304）、神经系统病变（OR = 1.023）、心功能衰竭（OR = 3.290）及恐惧（OR = 1.224）为影响患者情感状况的重要影响因素。 结论 慢性肾功能不全患者因自身需要长期接受治疗且病情反复而造成的心理问题应引起关注，与正常人群相比慢性肾功能不全患者存在严重心理问题，应及时采取针对性疏导。
　　[关键词] 慢性肾功能不全；情感障碍；抑郁；心理疏导
　　[中图分类号] R692.5 [文献标识码] C [文章编号] 1673-7210（2012）07（c）-0119-03
　　Current situation of emotional disorder in chronic renal insufficiency patients and Logistic regression analysis of its influence factors
　　ZHONG Honglin
　　The Second Hospital of Yulin City, Guangxi Zhuang Autonomous Region, Yulin 537000, China
　　[Abstract] Objective To evaluate the emotion between chronic renal insufficiency patients and normal people, in order to understand the emotional situation of chronic renal insufficiency patients． Methods 48 cases of chronic renal insufficiency patients were selected as the observation group, and 41 cases of physical examination people in outpatient service were selected as the control group. All 89 patients of the two groups were detected by self-rating anxiety scale (SAS)，self-rating depressing scale (SDS) and SCL-90 scale. Single factor analysis and unconditional multiple factors Logistic regression analysis methods were used to analyze the emotional state related factors of renal insufficiency patients. Results The scores and incidence of anxiety and depressing in the observation group were significantly higher than those of the control group (P < 0.01). Compared with the control group, the scores of SCL-90 in somzatization, interpersonal, depression, anxiety, terror, bigotry of the observation group were significantly different (P < 0.01). Multiple factors Logistic regression analysis results showed that the whole body complications (OR = 1.304), nerve system lesions (OR = 1.023), heart failure (OR = 3.290) and fear (OR = 1.224) were the important influence factors of emotional state. Conclusion Psychological problems caused by long-term treatment and illness relapses in chronic renal insufficiency patients should be paid attention. Compared with the normal group, chronic renal insufficiency patients have more severe psychological problems, and should give specific counseling.
　　[Key words] Chronic renal insufficiency; Etional disorder; Depression; Pychological counseling