标题：认知功能受损、共病数量对老年抑郁症患者生活质量的影响

      作者：秦碧勇 1，戴立磊 2，郑艳 3
    （1.湖北医药学院附属人民医院神经内科二病区，湖北 十堰 442000；
2.华中科技大学同济医学院附属同济医院康复医学科，湖北 武汉 430000；
(3.湖北医药学院附属人民医院护理部，湖北 十堰 442000)

      卷次： 2016年27卷16期

      【摘要】 目的 探讨老年抑郁症患者共病的现状，并分析认知功能受损及共病数量对其生活质量的影响。
方法 使用一般情况调查表、汉密尔顿抑郁量表(HAMD)、简易智力状态检查表(MMSE)和简明健康调查问卷
(SF-36)，采用横断面研究方法于 2012年 10至 2015年 10月对在我院精神科住院的 184例老年抑郁症患者进行调
查，按认知功能是否受损分为受损组121例，未受损组63例。结果 (1)两组患者一般资料比较，在年龄、受教育程
度、有无子女方面差异均有统计学意义(P<0.05)；(2)老年抑郁症患者共病的现状：呼吸系统疾病占73.4%，高血压占
68.5%，糖尿病占66.8%，失眠占57.6%，消化系统疾病占39.7%，冠心病占28.8%，外伤占7.1%，肿瘤占3.3%，脑中风
占 2.7%；(3)受损组患者的共病数量明显高于非受损组 [(4.34±1.15) vs (1.83±1.30)；t=13.482，P<0.01]；(4)精力
(vitality，VT)、受损组患者生活质量的生理机能(PF)、生理职能(RP)、一般健康状况(GH)、社会功能(SF)、情感职能
(RE)等因子评分明显低于未受损组，躯体疼痛(BP)、精神健康(MH)、健康变化(HT)等因子评分明显高于未受损组，
两组比较差异均有显著的统计学意义(P<0.01)；(5)认知功能评分、共病数量与生活质量各因子的评分均具有相关性
(P<0.05)，进一步多元线性逐步回归分析提示：MMSE评分是PF、RP、GH、SF、RE、MH、HT的影响因素；共病数量是
PF、RP、BP、VT、RE、HT的影响因素。结论 老年抑郁症认知功能受损的患者年龄明显较大、受教育程度较低、无
子女；共病疾病中更多见的是呼吸系统疾病、高血压、糖尿病等；认知功能受损患者共病数量更多、生活质量更差；
认知功能受损且共病数量较多患者的生理功能欠佳、健康状况更差，认知功能受损患者精神状态较差、影响患者的
社交功能，共病数量较多的患者精力感不足、躯体疼痛更多见。

      【关键词】 老年；抑郁症；共病；认知功能；生活质量

      【中图分类号】 R749.4 【文献标识码】 A 【文章编号】 1003—6350（2016）16—2594—05


Influence of cognitive function damage, co-morbidity numbers on the quality of life in elderly depressions.
QING
Bi-yong 1, DAI Li-lei 2, ZHENG Yan 3. 1. Division Two, Department of Neurology, Renmin Hospital Affiliated to Hubei
University of Medicine, Shiyan 442000, Hubei, CHINA; 2. Department of Rehabilitation, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan 430000, Hubei, CHINA; 3. Department of Nurseing, the
Affiliated People's Hospital of Hubei University of Medicine, Shiyan 442000, Hubei, CHINA

【Abstract】 Objective To investigate the status of elderly depression with personality disorder comorbidity, and
analyze the influence of cognitive function damage, co-morbidity numbers on the quality of life in elderly depressions.
Methods A total of 184 patients with elderly depressions, who admitted to Renmin Hospital Affiliated to Hubei Universi-
ty of Medicine from October 2012 to October 2015, were all measured with general questionnaire, HAMD, MMSE and
SF-36. These patients were divided into the cognitive function damage (n=121) and the normal cognitive function group
(n=63) according to whether there was cognitive function damage. Results (1) There were statistically significant differ-
ences between the two groups in the average data of age, education level and having children (P<0.05); (2) The status of el-
derly depression co-morbidity was as follows: respiratory diseases (73.4%), hypertension (68.5%), diabetes (66.8%), in-
somnia (57.6%), digestive disease (39.7%), coronary heart disease (28.8%), traumatism (7.1%), tumour (3.3%), stroke
(2.7%); (3) The number of co-morbidity in cognitive function damage group was significantly higher than that in normal
cognitive function group [(4.34±1.15) vs (1.83±1.30); t=13.482, P<0.01]; (4) The scores of Physical Functioning (PF), Role
Physical (RP), General Health (GH), Social Functioning (SF), Role-Emotional (RE) in cognitive function damage group
were significantly lower than those in normal cognitive function group, and the scores of Bodily Pain (BP), Mental Health
(MH), Reported Health Transition (HT) were significantly higher than those in normal cognitive function group; (5) The
scores of MMSE and co-morbidity number correlated with the SF-36 (P<0.05). The multiple linear regression showed that
the scores of MMSE had effects on PF, RP, GH, SF, RE, MH, HT of SF-36 and the co-morbidity number had effects on PF,
RP, BP, VT, RE, HT. Conclusion The elderly depressions with cognitive function damage characterized with an old age,
lower education level and no children. The most common of co-morbidity in the elderly depression are respiratory diseases,
hypertension and diabetes. The co-morbidity number in cognitive function damage group is more higher and the quality of
l