摘要:
目的 初步探讨脑胶质瘤患者术前的心理人格特征以及影响因素.方法 回顾性纳入2016年2月至2018年12月西南医科大学附属医院神经外科收治的85例脑胶质瘤患者(肿瘤组),术前行明尼苏达多项人格测查表(MMPI)评分;同时纳入同期心理卫生中心自愿接受MMPI评分的41名健康志愿者作为对照(健康对照组).对比两组MMPI的评分结果,进一步分析脑胶质瘤患者Kamafsky功能状态评分(KPS)、肿瘤级别、部位及侧别与MMPI评分的相关性.结果 两组在年龄、性别、文化程度、收入方面的差异均无统计学意义(均P >0.05).肿瘤组患者的说谎量表[(56.0±11.5)分]、诈病量表[(53.0±10.6)分]、疑病量表[(55.6±11.2)分]、抑郁量表[(49.2±9.6)分]、性度量表[(49.9±9.4)分]、精神衰弱量表[(51.5±10.0)分]、精神分裂症量表[(51.2±10.6)分]、轻躁狂量表[(51.8±9.1)分]及社会内向量表[(46.6±8.7)]的评分均高于健康对照组[分别为(50.0±10.0)分、(41.7±8.8)分、(44.2±8.3)分、(42.2±10.3)分、(42.8±14.0)分、(40.9±11.5)分、(40.2±10.6)分、(47.7±9.4)分、(36.7±13.0)分,均P<0.05],而防御量表的评分低于健康对照组[分别为(52.1±13.9)分、(58.8±12.1)分,P=0.009].KPS≤80分的脑胶质瘤患者的说谎量表、防御量表及癔病量表评分高于KPS评分> 80分者(均P<0.05);额颞叶胶质瘤患者的抑郁量表评分高于非额颞叶者(P<0.05);高级别脑胶质瘤患者的性度量表评分高于低级别者(P<0.05).右侧、左侧及双侧脑胶质瘤患者在各量表评分间的差异均无统计学意义(均P >0.05).结论 脑胶质瘤患者术前具有逃避、过度担心、情绪抑郁、紧张、焦虑等心理人格特征,KPS评分、肿瘤的级别和部位对其具有一定影响.%Objective To analyze the preoperative personal characteristics of glioma patients and to explore the association of their personal characteristics with clinical factors.Methods A retrospective analysis was conducted on 85 patients with gliomas (tumor group) who were admitted to Department of Neurosurgery of Affiliated Hospital of Southwest Medical University from February 2016 to December 2018.Minnesota Multiphasic Personality Inventory (MMPI) was used for assessment before surgery.Meanwhile,41 healthy volunteers who volunteered to undergo the MMPI assessment at Mental Health Center of Affiliated Hospital of Southwest Medical University during the same period were enrolled as controls (healthy control group).The results of MMPI scores were compared between the 2 groups.The relationship between Karnofsky Performance scale(KPS) score,tumor grade,location and side of patients with glioma and MMPI score was further analyzed.Results There was no significant difference in age,gender,education level or income between the 2 groups (all P >0.05).Compared with normal control group,the scores of 9 scales of MMPI in tumor group,including Lie (56.0 ± 11.5 vs.50.0 ±10.0),Validity (53.0 ± 10.6 vs.41.7 ± 8.8),Hypochondriasis (55.6 ± 11.2 vs.44.2 ± 8.3),Depression (49.2 ±9.6 vs.42.2 ± 10.3),Masculinity-femininity (49.9 ±9.4 vs.42.8 ± 14.0),Psychasthenia (51.5 ± 10.0 vs.40.9 ± 11.5),Schizophrenia (51.2 ± 10.6 vs.40.2 ± 10.6),Hypomania(51.8 ± 9.1 vs.47.7 ± 9.4),Social introversion (46.6 ± 8.7 vs.36.7 ± 13.0),were significant increased (all P < 0.05).Meanwhile,compared with normal control group,the score of Correction in tumor group was significant decreased (52.1 ± 13.9 vs.58.8 ±12.1,P =0.009).The scores of Lie,Correction,Hypochondriasis and Hysteria were significant different statistically between KPS >80 group and KPS≤80 group (P <0.05).The scores of Depression were significantly different between frontotemporal group and non-frontotemporal group (P < 0.05).Moreover,the scores of Masculinity-femininity were significantly different between low grade glioma group and high grade glioma group (P <0.05).There was no significant difference in the scores of each scale among right,left and bilateral glioma patients (all P > 0.05).Conclusions Patients with gliomas usually have some abnormal psychological personality,including evasion,over self-worry,emotional depression,nervousness,anxiety and so on.The KPS scores,tumor grade and location seem to have certain effects on their psychological personal characteristics respectively.