炎症性肠病与抑郁障碍共病影响因素研究

Influencing factors of the comorbidity between inflammatory bowel disease and depression

摘要:

目的 探寻炎症性肠病（inflammatory bowel disease, IBD）与抑郁障碍共病相关影响因素。方法 依托山东省某三级甲等综合医院“健康医疗大数据平台”，开展病例对照研究。以共病抑郁障碍的IBD患者为病例组，无抑郁障碍的IBD患者为对照组。根据病例组和对照组的年龄、性别进行1:2的倾向性评分匹配（propensity score matching, PSM），使用条件logistic回归模型分析IBD与抑郁障碍共病的相关影响因素。结果 共纳入405例IBD患者，其中包括270例无抑郁障碍患者和135例共病抑郁障碍患者。条件logistic回归结果表明，使用免疫抑制剂（OR=2.84, 95% CI: 1.00-8.07）、使用糖皮质激素（OR=2.05, 95% CI: 1.17-3.58），共患痴呆（OR=5.20, 95% CI: 1.59-17.05）、心血管疾病（OR=3.58, 95% CI: 1.84-6.98）和癌症（OR=2.63, 95% CI: 1.16-5.95）与IBD共病抑郁障碍之间存在关联。结论 应重点关注IBD人群中免疫抑制剂、糖皮质激素的使用情况以及痴呆、心血管疾病、癌症等躯体疾病共患情况，对高危人群采取早期预防和针对性治疗措施，降低其抑郁障碍发生风险，提高患者的生命健康质量。

Abstract:

Objective To investigate the influencing factors associated with the comorbidity of inflammatory bowel disease (IBD) and depression. Methods A case-control study was conducted based on the “Healthcare Big Data Platform” of a tertiary class-A comprehensive hospital in Shandong Province. IBD comorbid with depression was served as the case group and IBD without depression was served as the control group. Propensity score matching (PSM) was performed by matching the case group with the control group in a ratio of 1:2 according to the age and gender of the patients. Conditional logistic regression model was used to explore the influencing factors associated with the comorbidity of IBD and depression. Results A total of 405 patients with IBD were enrolled in this study, including 270 patients without depression and 135 patients comorbid with depression. The results of conditional logistic regression showed that the use of immunosuppressants (OR=2.84, 95% CI: 1.00-8.07) and glucocorticoids (OR=2.05, 95% CI: 1.17-3.58), dementia (OR=5.20, 95% CI:1.59-17.05), cardiovascular disease (OR=3.58, 95% CI: 1.84-6.98) and cancer (OR=2.63, 95% CI: 1.16-5.95) were associated with the comorbidity of depression and IBD. Conclusion Attention should be paid to the use of immunosuppressants and glucocorticoids in the population of IBD comorbid with depression, and the coexistence of physical diseases such as dementia, cardiovascular disease and cancer. Early prevention and targeted treatment measures should be taken for high-risk populations to reduce their risk of depression and improve their quality of life and health.