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大动脉炎患者抑郁的危险因素及预后

Risk factors and prognosis of depression in Takayasu arteritis patients.

作者信息

Zhang Yaxin, Fan Anyuyang, Du Juan, Shi Xuemei, Yang Shiyu, Gao Na, Pan Lili, Li Taotao

机构信息

Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of the National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

出版信息

Ther Adv Musculoskelet Dis. 2024 Nov 7;16:1759720X241296414. doi: 10.1177/1759720X241296414. eCollection 2024.

Abstract

BACKGROUND

Takayasu arteritis (TA) is associated with an increased risk of developing complicated comorbidities, which can bring both psychological and physical burdens to the patients.

OBJECTIVE

TA is found to carry a high risk of developing depression. This research aimed to investigate the risk factors and prognosis of depression in TA patients.

DESIGN

A longitudinal observation cohort was conducted on TA patients with or without depression to explore the clinical characteristics.

METHODS

In this cohort study, 90 TA patients were split into two groups with or without depression. Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS) in TA patients. TA patients with depression were followed up for at least 3 months. We used multivariate logistic regression analysis to find the risk factors and Kaplan-Meier curve analysis to determine the prognosis.

RESULTS

We concluded 90 TA patients in this research, 29 of whom were in depression. Indian Takayasu's Arteritis Activity Score (ITAS2010) ⩾2 (odds ratio (OR) (95% confidence interval, CI) 26.664 (2.004-354.741),  = 0.013), interleukin-6 (IL-6) (OR (95% CI) 1.070 (1.022-1.121),  = 0.004), prednisone equivalents (OR (95% CI) 1.101 (1.030-1.177),  = 0.005), and carotidynia (OR (95% CI) 5.829 (1.142-29.751),  = 0.034) have been shown independent risk factors for depression in TA patients. We also identified the association between disease remission with the improvement of HADS-D score (Log-rank  = 0.005, hazard ratio (HR) 0.25) and depression (Log-rank  = 0.043, HR 0.28).

CONCLUSION

Aggressive treatment to achieve remission can promote improvement of depression in patients with TA. Screening for depression should also be performed in patients with elevated disease activity, IL-6, glucocorticoid use, and carotidynia.

摘要

背景

大动脉炎(TA)与发生复杂合并症的风险增加相关,这会给患者带来心理和身体负担。

目的

发现TA患者发生抑郁症的风险较高。本研究旨在调查TA患者抑郁症的危险因素和预后。

设计

对有或无抑郁症的TA患者进行纵向观察队列研究,以探索其临床特征。

方法

在这项队列研究中,90例TA患者被分为有或无抑郁症两组。通过医院焦虑抑郁量表(HADS)对TA患者进行抑郁评估。对患有抑郁症的TA患者进行至少3个月的随访。我们使用多因素逻辑回归分析来寻找危险因素,并使用Kaplan-Meier曲线分析来确定预后。

结果

本研究共纳入90例TA患者,其中29例患有抑郁症。印度大动脉炎活动评分(ITAS2010)≥2(比值比(OR)(95%置信区间,CI)26.664(2.004 - 354.741),P = 0.013)、白细胞介素-6(IL-6)(OR(95%CI)1.070(1.022 - 1.121),P = 0.004)、泼尼松等效剂量(OR(95%CI)1.101(1.030 - 1.177),P = 0.005)和颈动脉痛(OR(95%CI)5.829(1.142 - 29.7

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e62d/11544677/262e1d13ea54/10.1177_1759720X241296414-fig1.jpg

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