性别及心理因素对肠易激综合征患者生活质量的影响

摘要

目的：探讨性别及性别相关心理差异对肠易激综合征(IBS)患者生活质量的影响。方法 由消化科医师对IBS患者进行问卷调查，问卷内容包括：一般人口学资料、焦虑和抑郁量表、生活质量量表。统计调查资料、分析IBS患者性别及性别相关心理差异对生活质量的影响。结果根据罗马Ⅲ标准收集IBS患者452例，年龄分布在14 ～79岁；男193例(42.7％)，女259例(57.3％)，男女比例为1∶1.3。女性IBS患者SAS、SDS评分分别为(53.57±6.70)分、(40.81±7.15)分，男性分别为(49.19±5.99)分、(36.67±6.40)分，女性患者均明显高于男性患者(t=7.191、6.459，均P＜0.01)。女性IBS患者IBS-QOL总分低于男性IBS患者(t =9.119，P＜0.01)。在量表包括的8个纬度中，女性IBS患者在烦躁不安、身体角色、健康忧虑、社会反应、异性概念等5个纬度得分低于男性(t =11.021、22.175、7.256、10.409、7.113，均P＜0.01)，在冲突行为、饮食限制、家庭关系等3个纬度与男性无明显差异(均P ＞0.05)。IBS患者SAS、SDS评分与IBS-QOL评分(总分及各个纬度评分)均呈明显负相关(均P＜0.01)。结论性别不同IBS患者存在心理及生活质量差异，IBS患者性别相关的心理差异影响患者的生活质量。%Objective To investigate the influence of gender and psychosocial parameters on the quality of life in patients with irritable bowel syndrome(IBS). Methods Out-patients from Jan to Oct 2008 in the Department of Gastroenterology at the First Affiliated Hospital of Nanjing Medical University were enrolled. Based on Rome teria IBS was diagnosed. Interviewed by a GI physician with questionnaire of demographic data,Zung self-rating anxiety and depression scale(SAS/SDS) and IBS-specific quality of life(IBS-QOL) questionnaire. Results 452 patients were diagnosed as IBS according to Rome Ⅲ criteria. IBS was more common in female. In male, anxiety and depression scales were significantly increased( t =7. 191、6. 459 ,P ＜ 0. 01 ) and the scale of IBS-QOL was significantly decreased ( t =9.119, P ＜ 0.01 ) in female IBS patients. In IBS patients, IBS-QOL scales were negatively associated with the anxiety and depression scales(P ＜0. 01 ). Conclusion These results suggest that there were gender differences in psychological status and quality of life in IBS patients,and difference psychological status based on gender should influence the quality of life of patients with IBS.