摘要
目的:探讨巴塞罗那(BCLC)B/C期肝癌患者术前抑郁的相关因素及对免疫功能的影响。方法:对160例BCLC-B/C期肝癌患者术前采用一般资料调查表、医院焦虑抑郁量表(HADS)、患者健康问卷9(PHQ-9)和NRS疼痛数字评价量表进行问卷调查,用logistics回归分析BCLC-B/C期肝癌患者术前不同抑郁程度(无抑郁、轻度抑郁、中重度抑郁)的相关因素;同时测定IgG、IgM、IgA、补体C3、补体C4、C反应蛋白(CRP)、超敏C反应蛋白(hs-CRP)、CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD3^+CD4^+/CD3^+CD8^+、CD3-CD16^+CD56^+(NK细胞)、CD19^+、中性粒细胞/淋巴细胞比值(NLR)含量。结果:160例BCLC-B/C期肝癌患者中抑郁的发生率为64.4%(103/160),其中无抑郁57例(35.6%)、轻度抑郁63例(39.4%)、中重度抑郁40例(25%)。回归分析显示抑郁与年龄、社会支持、经济状况、疼痛相关,差异有统计学意义(P<0.05);随着抑郁程度的增加,患者NLR、CRP、hs-CRP、CD3^+CD8^+含量呈递增趋势,CD3^+、CD3^+CD4^+、CD3^+CD4^+/CD3^+CD8^+、CD3^-CD16^+CD56^+含量呈递减趋势,差异有统计学意义(P<0.05)。结论:BCLC-B/C期肝癌患者术前抑郁发生率较高,年龄、社会支持、经济状况、疼痛是患者术前抑郁的相关因素,抑郁能引起患者免疫功能低下,应寻找针对性的个体化心理干预措施,改善患者抑郁情绪和免疫功能。
Objective：To investigate the influencing factors of preoperative depression and the effect on the immune function for patients with barcelona clinic liver cancer B or C stage disease.Methods：A total of 160 preoperative patients with BCLC B or C were investigated and assessed by using general information questionnaire,hospital anxiety and depression scale（ HADS）,9 items patients＇ health questionnaire depression scale（ PHQ-9） and numerical rating scale（ NRS）.Depression and influencing factors was analyzed by multivariate logistic regression for patients with BCLC B or C.And the lever of Ig G,Ig M,Ig A,complement C3,complement C4,c-reactive protein（ CRP）,hypersensitive c-reactive protein（ hs-CRP）,CD3^＋,CD3^＋CD4^＋,CD3^＋CD8^＋,CD3^＋CD4^＋/CD3^＋CD8^＋,CD3^-CD16^＋CD56^＋（ NK cell）,CD19^＋,ratio of neutrophil and lymphocyte（ NLR） were detected.Results：The incidence of depression in patients with BCLC B or C was 64.4%（ 103/160）,among them,57 patients with no depression accounted for 35.6%,63 patients with mild depression accounted for 39.4%,40 patients with moderately or severe depression accounted for 25%.Regression analysis showed that the influencing factors of preoperative depression were age,social support,economic status and pain,with statistical significance（ P〈0.05）,the lever of the NLR,CRP,hs-CRP,CD3^＋CD8^＋with a positive trend of the increasing depression,the lever of CD3^＋、CD3^＋CD4^＋、CD3^＋CD4^＋/CD3^＋CD8^＋、CD3^-CD16^＋CD56^＋（ NK cell） with a negative trend of the increasing depression,with statistical significance（ P〈0.05）.Conclusion：the incidence of depression for patients with BCLC B or C were high,the influencing factors of preoperative depression were age,social support,economic status and pain,which can weak the immune system,the effective individualized psychological intervention should be found to improve patients depression and immune function.
作者
赵凌云
韦珏伶
赵新华
唐娟
李秋琴
谢容蔚
霍荣瑞
游雪梅
Zhao Lingyun;Wei Jueling;Zhao Xinhua;Tang Juan;Li Qiuqin;Xie Rongwei;Huo Rongrui;You Xuemei(Department of Hepatobiliary Surgery,Affiliated Cancer Hospital of Guangxi Medical University,Guangxi Nanning 530021,China.)
出处
《现代肿瘤医学》
CAS
2018年第11期1727-1732,共6页
Journal of Modern Oncology
基金
国家科技重大专项课题(编号:2012(X10002010001009)
广西卫计委中医药科技专项课题(编号:GZLC16-36)
广西医疗卫生适宜技术研究与开发课题(编号:S201417-03)
关键词
巴塞罗那临床肝癌分期
肝癌
抑郁
影响因素
免疫
barcelona clinic liver cancer B or C stage
liver cance
depression
influencing factors
immune
