Stasiewski E, Christoph M, Christoph A, Bittner A, Weidner K, Julius U
Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Fetscherstr.74, 01307 Dresden, Germany.
Heart Center, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Germany.
Atheroscler Suppl. 2015 May;18:233-40. doi: 10.1016/j.atherosclerosissup.2015.02.035.
Despite the fact that extracorporeal methods such as lipoprotein apheresis (LA) and hemodialysis (HD) are highly effective in improving the physical status of patients, these treatment options may possibly harm the psychological status and the health related quality of life (HRQL).
The occurrences of anxiety, depression and the HRQL of 111 study participants treated with LA (n = 41), HD (n = 41) or undergoing plateletpheresis (PD) (n = 29) were compared to the normal population (NP), using standardized questionnaires (anxiety and depression: Hospital Anxiety and Depression Scale (HADS), heart-focused anxiety: Cardiac Anxiety Questionnaire (CAQ) and HRQL: Short-Form Health Survey (SF-12)). Additionally, the subjective mental and physical stress of study participants was evaluated.
LA females had a significantly elevated HADS-A score compared to PD and NP. Additionally, there was a trend toward higher HADS-A scores in the LA group compared to the HD group in females. In HD males HADS-A and -D scores increased compared to PD and NP. The CAQ revealed a significant increase in the CAQ-Fear scale in LA compared to HD and PD participants. The CAQ-Avoidance score showed significantly increased scores in LA and HD patients compared to PD and NP. In the CAQ-Attention scale the LA patients also showed significantly increased scores compared to PD and NP. The increased psychological symptoms were associated with significantly lower levels of objective and subjective HRQL in LA and HD patients compared to PD and NP.
LA and HD patients had similarly increased presence of psychological symptoms with concurrent decreased quality of life compared to PD and the normal population, which may affect the outcome of the LA patients. Therefore, early psychosomatic screening and probable psychosomatic treatment should be performed.
尽管诸如脂蛋白分离术（LA）和血液透析（HD）等体外治疗方法在改善患者身体状况方面非常有效，但这些治疗选择可能会损害患者的心理状态和健康相关生活质量（HRQL）。
使用标准化问卷（焦虑和抑郁：医院焦虑抑郁量表（HADS）、心脏聚焦焦虑：心脏焦虑问卷（CAQ）和HRQL：简短健康调查问卷（SF-12）），将111名接受LA治疗（n = 41）、HD治疗（n = 41）或进行血小板单采术（PD）（n = 29）的研究参与者的焦虑、抑郁发生率及HRQL与正常人群（NP）进行比较。此外，对研究参与者的主观心理和身体压力进行了评估。
与PD组和NP组相比，LA组女性的HADS-A评分显著升高。此外，女性中LA组的HADS-A评分有高于HD组的趋势。与PD组和NP组相比，HD组男性的HADS-A和-D评分升高。CAQ显示，与HD组和PD组参与者相比，LA组的CAQ-恐惧量表显著增加。与PD组和NP组相比，LA组和HD组患者的CAQ-回避评分显著升高。在CAQ-注意力量表中，LA组患者的评分也显著高于PD组和NP组。与PD组和NP组相比，LA组和HD组患者心理症状增加，同时客观和主观HRQL水平显著降低。
与PD组和正常人群相比，LA组和HD组患者心理症状的出现率同样增加，同时生活质量下降，这可能会影响LA组患者的治疗结果。因此，应尽早进行身心筛查并可能进行身心治疗。
