来源：风湿病与关节炎,2019,8（11）:15-19.

135例类风湿关节炎患者感受的变化及其相关性分析

（临床研究）

张　颖¹，刘　健²，黄　旦¹，万　磊²，龙　琰¹，鲍丙溪¹，孙广瀚¹

【摘　要】目的：观察类风湿关节炎患者感受变化及其与指标间的相关性。方法：选取安徽中医药大学第一附属医院诊治的135例类风湿关节炎患者，发放患者感受量表［焦虑自评量表（SAS）、抑郁自评量表（SDS）、简明健康状况调查问卷表（SF-36）］，并观察患者的临床指标。分析患者感受变化及其与临床指标间的相关性及关联性。基于SAS及SDS将患者分为2组，对比其指标的差异。结果：①135例患者中，SAS异常者60例（44.44%），SDS异常者38例（28.15%），两者均异常者20例（14.81%）；且SF-36量表中，生理机能（PF）、生理职能（RP）、躯体疼痛（BP）、活力（VT）、情感职能（RE）、精神健康（MH）较常模组明显下降。②Spearman分析显示，SAS、SDS与类风湿因子（RF）、超敏C-反应蛋白（hs-CRP）、红细胞沉降率（ESR）等免疫炎症指标呈正相关；SF-36与SAS、SDS、RF、ESR、hs-CRP等呈负相关。③关联规则分析表明，SAS升高与hs-CRP、ESR、抗环瓜氨酸肽抗体（抗CCP抗体）升高有明显关联性；SDS升高与RF、ESR升高有明显关联性。④与正常组比较，SAS异常组患者的RF、hs-CRP显著升高；SDS异常组RF、抗CCP抗体、CRP、补体C4多数类风湿关节炎患者存在患者感受的异常，且患者感受与疾病的活动度及免疫炎症代谢指标关系密切，焦虑、抑郁患者的实验室指标较高。

　　【关键词】　关节炎，类风湿；焦虑；抑郁；患者感受；相关性分析

Feeling Changes of 135 Patients with Rheumatoid Arthritis and Related Analyses

ZHANG Ying,LIU Jian,HUANG Dan,WAN Lei,LONG Yan,BAO Bing-xi,SUN Guang-han

　　【ABSTRACT】Objective:To observe the feeling changes of patients with rheumatoid arthritis and the correlation between the changes and the indexes.Methods:One hundred and thirty five patients with rheumatoid arthritis diagnosed and treated in the First Affiliated Hospital of Anhui University of Chinese Medicine were selected and given the Patient's Feeling Scale（SAS,SDS,SF-36）,observing their clinical indexes and analyzing the relationship between the their feeling changes and clinical indexes.The patients were divided into two groups based on SAS and SDS,and the differences of their indexes were compared.Results:①Of all the patients,60（44.44%）had abnormal SAS,38（28.15%）had abnormal SDS,and 20（14.81%）had abnormal SAS and SDS.In the SF-36 scale,PF,RP,BP,VT,RE and MH were significantly lower than those in the normal group.②Spearman analysis showed that SAS and SDS were positively correlated with indicators of immune inflammation such as RF,hs-CRP and ESR.SF-36 was negatively correlated with SAS,SDS,RF,ESR and hs-CRP.③Analysis based on association rules showed that the increase of SAS was significantly related to the increase of hs-CRP,ESR and anti-CCP antibody,while the increase of SDS was significantly related to the increase of RF and ESR.④Compared with the normal group,the RF and hs-CRP of the SAS abnormal group were significantly higher,and the RF,anti-CCP antibody,CRP and complement C4 of the SDS abnormal group were significantly higher.Conclusion:Most patients with rheumatoid arthritis have abnormal feelings,which are closely related to the activity of disease and the index of immune inflammation metabolism.The laboratory indexes of patients with anxiety and depression are higher.

　　【Keywords】 arthritis,rheumatoid;anxiety;depression;patients' feelings;correlation analysis