慢性额窦炎患者焦虑抑郁特点及横断面研究

Characteristics and influencing factors of anxiety and depression in patients with chronic frontal sinusitis

摘要

目的 调查慢性额窦炎患者焦虑和抑郁的特征,并探讨额窦炎症状是否是患者焦虑、抑郁的危险因素。方法 前瞻性地选取126例确诊的慢性额窦炎患者,采用Zung焦虑自评量表(self-rating anxiety scale, SAS)、Zung抑郁自评量表(self-rating depression scale, SDS)、鼻腔鼻窦结局测量22条(sino-nasal outcome test-22, SNOT-22)、视觉模拟量表(visual analogue scale, VAS)、Lund-Mackay CT评价系统、Lund-Kennedy内镜评价系统进行术前心理状态、生活质量和疾病严重程度的评估,并与我国标准常模进行对比,进行统计学分析。结果 120例有效病例中,术前27.50%的患者有不同程度的焦虑,30.00%的患者有不同程度的抑郁。焦虑抑郁水平明显高于中国常模,差异有统计学意义(t=10.906,P<0.001;t=2.162,P=0.031)。性别、年龄、身高、体质量、是否合并高血压或糖尿病、内镜评分和CT评分对焦虑及抑郁程度无明显影响(P>0.05)。鼻痒、流泪、咳嗽、喘息、头昏头痛、睡眠问题是加重慢性额窦炎患者焦虑的独立危险因素;流涕、眼红肿、睡眠问题是加重慢性额窦炎患者抑郁的独立危险因素(P<0.05)。结论 慢性额窦炎患者术前焦虑抑郁情绪明显高于普通人群。症状严重程度的加重提高了患者的焦虑抑郁水平,睡眠问题是加重患者焦虑与抑郁的共同独立危险因素。应加强对患者的心理评估和干预,以提高治疗效果和患者的生活质量。

Abstract

Objective To investigate the characteristics of anxiety and depression in patients with chronic frontal sinusitis and to explore whether frontal sinusitis symptoms constitute risk factors for anxiety and depression in patients. Methods A prospective cohort of 126 patients with confirmed chronic frontal sinusitis was enrolled. All patients were assessed via questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Zung Self-Rating Depression Scale (SDS), the symptom visual analog scale (VAS), the 22-item Sino-Nasal Outcome Test (SNOT-22), Lund-Mackay CT scoring system, and Lund-Kennedy endoscopic score to assess psychological status, quality of life, and disease severity preoperatively. Results were compared with Chinese standard norms and subjected to statistical analysis. Results Among the 120 effective cases, 27.50% of patients exhibited varying degrees of anxiety and 30.00% showed varying degrees of depression prior to surgery. Anxiety and depression levels were significantly higher than the Chinese normative values, with statistically significant differences (t=10.906, P<0.001; t=2.162, P=0.031). There was no significant difference in terms of age, gender, presence of diabetes or hypertension, endoscopic score, or CT score between the normal control subjects and patients with anxiety or depression levels (P>0.05). Nasal itching, tearing, coughing, wheezing, dizziness headaches, and sleep problems are independent risk factors for increased anxiety in patients with chronic frontal sinusitis; nasal discharge, eye redness and swelling, and sleep problems are independent risk factors for increased depression in patients with chronic frontal sinusitis (P<0.05). Conclusion Patients with chronic frontal sinusitis exhibit significantly higher levels of preoperative anxiety and depression compared to the general population. Increased symptom severity elevates anxiety and depression levels, while sleep disturbances serve as a common independent risk factor exacerbating these conditions. Enhanced psychological assessment and intervention are warranted to improve treatment outcomes and patient quality of life.

关键词

慢性鼻窦炎 / 额窦炎 / 焦虑 / 抑郁 / 横断研究

Key words

Chronic rhinosinusitis / Frontal sinusitis / Anxiety / Depression / Cross-sectional study

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基金资助

新疆生产建设兵团2024年度人才发展基金(CZ001213(2024)第97号)