中国阻塞性睡眠呼吸暂停患者抑郁状态的患病率及相关因素：一项大样本调查
Prevalence and Predisposing Factors for Depressive Status in Chinese Patients with Obstructive Sleep Apnoea: A Large-Sample Survey.
作者信息
Dai Yaozhang, Li Xuewu, Zhang Xin, Wang Sihua, Sang Jianzhong, Tian Xiufen, Cao Hua
机构信息
Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China.
Shenzhen Kangning Hospital, Shenzhen Key Lab for Psychological Healthcare, Shenzhen, Guangdong, China.
出版信息
PLoS One. 2016 Mar 2;11(3):e0149939. doi: 10.1371/journal.pone.0149939. eCollection 2016.
BACKGROUND AND OBJECTIVE
Recently, there are few studies reporting on depressive status and obstructive sleep apnoea (OSA) in China. A large-sample survey was to be performed to explore the prevalence of depressive status and related factors in Chinese patients with OSA.
METHODS
From among a randomly-selected group of OSA patients, 1,327 met inclusion criteria. After screening with the Symptom Checklist 90 (SCL-90) and Self-Rating Depression Scale (SDS), patients were assigned to OSA without depressive status (control group, n = 698) and OSA with depressive status (n = 629) groups. Using chi-squared testing, the correlation analyses between the depressive status and OSA patient demographic and clinical variables were tested. Then depression-related risk factors in OSA patients were analysed using stepwise linear regression analysis. The effects of family and social factors on depressive status in OSA patients were investigated using Mann-Whitney U (one of nonparametric test).
RESULTS
The prevalence of depressive status was 47.4% in OSA patients. Depressive status was significantly associated with female gender, single status, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), apnoea-hypopnea index (AHI), and Perceived Social Support Scale (PSSS). Stepwise linear regression analysis further indicated that single status, hypoxemia, APGAR, AHI, PSSS, AHI, and FBS were all risk factors for depressive status in OSA patients. The total of the FBS score and three of its sub-factors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its sub-factors scores (adaptability and affection) were lower in OSA with depressive status compared with the control group. Besides, the total score for the PSSS and scores for its two sub-factors (family support and social support) were all lower in OSA patients with depressive status than those of the control group.
CONCLUSIONS
Depressive status has high comorbid rate in Chinese OSA patients and is significantly associated with single status, apnoea-hypopnea index, hypoxemia, family and social supports.
背景与目的
近年来，中国关于抑郁状态与阻塞性睡眠呼吸暂停（OSA）的研究较少。本研究拟通过大样本调查，探讨中国阻塞性睡眠呼吸暂停患者抑郁状态的患病率及其相关因素。
方法
从随机选取的阻塞性睡眠呼吸暂停患者中，筛选出1327例符合纳入标准的患者。采用症状自评量表（SCL - 90）和自评抑郁量表（SDS）进行筛查，将患者分为无抑郁状态的阻塞性睡眠呼吸暂停组（对照组，n = 698）和有抑郁状态的阻塞性睡眠呼吸暂停组（n = 629）。采用卡方检验分析抑郁状态与阻塞性睡眠呼吸暂停患者人口统计学及临床变量之间的相关性。然后采用逐步线性回归分析阻塞性睡眠呼吸暂停患者抑郁相关危险因素。采用曼 - 惠特尼U检验（非参数检验之一）研究家庭和社会因素对阻塞性睡眠呼吸暂停患者抑郁状态的影响。
结果
阻塞性睡眠呼吸暂停患者抑郁状态的患病率为47.4%。抑郁状态与女性、单身状态、家庭疾病负担量表（FBS）、家庭功能评定量表（APGAR）、呼吸暂停低通气指数（AHI）及领悟社会支持量表（PSSS）显著相关。逐步线性回归分析进一步表明，单身状态、低氧血症、APGAR、AHI、PSSS、AHI及FBS均为阻塞性睡眠呼吸暂停患者抑郁状态的危险因素。与对照组相比，有抑郁状态的阻塞性睡眠呼吸暂停组FBS总分及其三个子因子得分（家庭日常活动、家庭关系及家庭成员心理健康）较高，APGAR总分及其两个子因子得分（适应性及情感）较低。此外，有抑郁状态的阻塞性睡眠呼吸暂停患者PSSS总分及其两个子因子得分（家庭支持及社会支持）均低于对照组。
结论
中国阻塞性睡眠呼吸暂停患者抑郁状态的共病率较高，且与单身状态、呼吸暂停低通气指数、低氧血症、家庭及社会支持显著相关。
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