系统性红斑狼疮患者抑郁症状及其影响因素的纵向研究

摘要

目的 研究系统性红斑狼疮(SLE)患者的抑郁症状及其与疾病活动性、激素累积剂量和SLE其他因素之间的相关性.方法 采用12个月的纵向研究设计,共选定两个观察时间点:疾病活动期与疾病缓解期.选择门诊和住院的62例SLE患者,采用CES-D抑郁自评量表进行问卷调查,同时记录患者的疾病活动度评分(SLEDAI)、激素累积剂量及SLE相关因素.应用Spearman等级相关分析方法分析抑郁与上述指标之间的相关性.结果 SLE疾病活动期30例(48％) SLE患者出现抑郁,缓解期13例(23％),两组比较差异有统计学意义(P＜0.01).大专组以上患者及≤50岁者抑郁的发生率高(P＜0.05).Spearman等级相关分析方法显示,在SLE活动期,抑郁与SLE活动性指数(SLEDAI) (P＜0.01)、病程相关(P＜0.05).在SLE稳定期,抑郁与病程、激素总剂量不相关(P＞0.05).结论 无论在SLE的活动期还是缓解期,均存在一定程度的抑郁症状.SLE疾病活动可能在抑郁的发生发展中起了一定的作用.%Objective To observe the prevalence of depression in patients with systemic lupus erythematosus (SLE) and the relationship between depression and the disease activity, dosage of glucocorticoid and SLE related factors. Methods A 12-month longitudinal study was conducted in 62 patients with SLE by questionnaires in one week after treatment and 12 months later. Depression was assessed by CES-D. The Systemic Lupus Erythematosus Activity Index (SLEDAI) was recorded. The relationship between CES-D and and SLE related factors were analyzed by Spearman's rank correlation coefficient. Results The incidence of depression was 48% (30/62) in the active stage of the disease, and 23% (13/62) in remission (P<0.01), with statistically significant difference (P<0.01). The incidence was rnsignificantly higher in patients with associate degree or higher and in patients younger than 50 years old (P<0.05). The level of depression was related with SLEDAI (P<0.01) and disease course (P<0.05) in active stage. Conclusion SLE patients have depression symptoms to the certain extent throughout the whole course of disease. SLE disease activity may play a role in the development of depression in SLE.