来源：风湿病与关节炎,2019,8（12）:22-26.

66例骨关节炎患者感受及其相关性分析（临床研究）

鲍丙溪，刘　健，忻　凌，张　颖，龙　琰，孙广瀚，孙艳秋

　　【摘　要】目的：基于简明健康状况调查问卷表（SF-36）、焦虑自评量表（SAS）、抑郁自评量表（SDS）探究骨关节炎患者感受及其相关性分析。方法：由患者填写问卷的形式得到SF-36、疼痛视觉模拟评分法（VAS）评分、SAS和SDS的各项积分，通过临床血液检查得出红细胞沉降率（ESR）、超敏C-反应蛋白（hs-CRP）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、三酰甘油（TG）、α1-酸性糖蛋白（α1-AGP）、免疫球蛋白（IgA、IgG、IgM）、补体（C3、C4）指标值。结果：①66例骨关节炎患者中，38.80%存在轻度抑郁，24.88%存在中度抑郁，4.48%存在重度抑郁；28.36%存在轻度焦虑，16.42%存在中度焦虑，2.96%存在重度焦虑。②从免疫炎症代谢指标与SAS、SDS相关性看出，hs-CRP与SDS呈正相关（P < 0.05）。③骨关节炎患者焦虑、抑郁与免疫炎症代谢指标的关联规则得出，SAS和SDS上升与ESR上升有关，支持度均 > 45%，最小置信度均 > 50%，提升度 > 1。④SF-36比较显示，骨关节炎患者项目评分与中国常模组比较，差异均有统计学意义（P < 0.05），骨关节炎患者SF-36量表各维度总积分为（340.52±77.56）分。⑤生理机能（PF）与VAS、SAS、SDS、ESR呈正相关（P < 0.05或P < 0.01）；生理职能（RP）与hs-CRP、SDS呈正相关，与IgM呈负相关（P < 0.05或P < 0.01）；躯体疼痛（BP）与ESR、hs-CRP呈正相关（P < 0.01）；活动（VT）与SDS呈正相关（P < 0.01）；社会功能（SF）与IgM呈负相关（P < 0.05）；精神健康（MH）与SDS呈正相关、与IgG呈负相关（P < 0.05或P < 0.01）；一般健康状况（GH）、情感职能（RE）与相关指标无相关性（P ＞ 0.05）。结论：骨关节炎患者感受明显较差，疾病活动度、躯体的疼痛、焦虑抑郁的状态、免疫炎症反应与之有密切关系，加强骨关节炎患者心理及生理的干预，对于提高患者生活质量尤为重要。

　　【关键词】　骨关节炎；患者感受；生活质量；相关性

Feelings of 66 Patients with Osteoarthritis and the Correlation Analysis

BAO Bing-xi,LIU Jian,XIN Ling,ZHANG Ying,LONG Yan,SUN Guang-han,SUN Yan-qiu

　　【ABSTRACT】Objective:To explore feelings of patients with osteoarthritis and make correlation analyses based on SF-36,SAS and SDS.Methods:Scores of SF-36,VAS,SAS and SDS were obtained.ESR,hs-CRP,HDL-C,LDL-C,TC,TG,α1-AGP,IgA,IgG,IgM,C3 and C4 were also obtained by blood test.Results:①Among the 66 patients,38.80% of them had mild depression,24.88% had moderate depression,4.48% had severe depression,28.36% had mild anxiety,16.42% had moderate anxiety,and 2.96% had severe anxiety.②There was a positive correlation between hs-CRP and SDS（P < 0.05）.③According to the association rules of anxi-ety,depression and immune inflammatory metabolic indexes in patients with osteoarth-ritis,the increase of SAS and SDS was related to the increase of ESR,with the support degree over 45%,the minimum confidence degree over 50%,and the improvement degree over 1.④SF-36 comparison showed that there was a statistically significant difference between the item scores of osteoarthritis patients and the Chinese norm group（P < 0.05）.The total score of each dimension of SF-36 scale of osteoarthritis patients was（340.52±77.56）.⑤PF was positively correlated with VAS,SAS,SDS and ESR（P < 0.05 or P < 0.01）;RP was positively correlated with hs-CRP and SDS and negatively correlated with IgM（P < 0.05 or P < 0.01）;BP was positively correlated with ESR and hs-CRP（P < 0.01）;VT was positively correlated with SDS（P < 0.01）;SF was negatively correlated with IgM（P < 0.05）;MH was positively correlated with SDS and negatively correlated with IgG（P < 0.05 or P < 0.01）;GH and RE were not correlated with related indexes（P > 0.05）.Conclusion:Patients with osteoarthritis feel worse.Disease activity,body pain,anxiety and depression,and immune inflammatory response are closely related to them.Strengthening the psychological and physiological intervention for patients with osteoarthritis is particularly important to improve the life quality of patients.

　　【Keywords】 osteoarthritis;patients’ feelings;life quality;correlation