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压力状况、应对方式、焦虑、抑郁和胃排空情况作为功能性消化不良预测因素的研究:病例对照研究。

Stress profile, coping style, anxiety, depression, and gastric emptying as predictors of functional dyspepsia: a case-control study.

机构信息

División de Ciencias e Ingenierías, Departamento de Ingeniería Física, Universidad de Guanajuato, León, Guanajuato, México.

出版信息

J Psychosom Res. 2010 Jan;68(1):73-81. doi: 10.1016/j.jpsychores.2009.05.013.


DOI:10.1016/j.jpsychores.2009.05.013
PMID:20004303
Abstract

OBJECTIVE: To determine whether gastric emptying, stomach peristaltic frequencies, stress profile, depressive symptoms, anxiety, and salivary cortisol levels could predict functional dyspepsia (FD). METHODS: Magnetogastrography (MGG) was used to measure gastric emptying time and the gastric peristaltic frequencies in 15 patients with FD diagnosis and in 17 healthy volunteers. In all the participants, stress profile, anxiety, and depressive symptoms were evaluated by means of standardized questionnaires, and morning salivary samples were collected for the measurement of cortisol levels. A univariate logistic regression model was used to examine the probability of the measured variables to predict the presence of FD. RESULTS: The univariate logistic regression model showed that the half-time of gastric emptying (OR=1.16 P=.01); the subscale of stress items (OR=1.08, P=.003); negative appraisal of subscale coping strategies (OR=1.03, P=0.007); anxiety (OR=1.05, P=.01); and depression (OR=1.23, P=.02) had a significant predictive value for the presence of FD. However, by applying the stricter multiple comparison criteria, only stress, negative appraisal, and anxiety arose as predictors of FD. The FD patients compared with healthy volunteers showed significantly elevated half-time of gastric emptying (P<.0006), high scores in the subscales of stress (P<.000003), in behavior type "A" (P<.04), in coping styles (P<.008), in depression (P<.0004), and in anxiety (P<.0002). CONCLUSIONS: These findings indicate that psychosocial stress, mood symptoms, and coping style are predictors of FD. The stress shows high sensibility and specificity in the patients with FD, indicating a contribution in the etiopathogenesis of dyspepsia.

摘要

目的:探讨胃排空、胃蠕动频率、应激状态、抑郁症状、焦虑和唾液皮质醇水平是否可预测功能性消化不良(FD)。

方法:采用磁控胃电图(MGG)检测 15 例 FD 患者和 17 例健康志愿者的胃排空时间和胃蠕动频率。采用标准化问卷评估所有参与者的应激状态、焦虑和抑郁症状,并采集早晨唾液样本测量皮质醇水平。采用单变量逻辑回归模型分析各测量变量预测 FD 发生的概率。

结果:单变量逻辑回归模型显示,胃排空半时(OR=1.16,P=.01);应激项目子量表(OR=1.08,P=.003);应对策略负性评价子量表(OR=1.03,P=0.007);焦虑(OR=1.05,P=.01);抑郁(OR=1.23,P=.02)对 FD 的发生有显著的预测价值。然而,采用更为严格的多重比较标准后,只有应激、负性评价和焦虑被认为是 FD 的预测因素。与健康志愿者相比,FD 患者的胃排空半时明显延长(P<.0006),应激子量表评分(P<.000003)、A型行为(P<.04)、应对方式(P<.008)、抑郁(P<.0004)和焦虑(P<.0002)评分均升高。

结论:这些发现表明,心理社会应激、情绪症状和应对方式是 FD 的预测因素。应激在 FD 患者中具有较高的敏感性和特异性,表明其在消化不良的发病机制中起作用。

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