强直性脊柱炎患者功能状态与焦虑抑郁情绪的相关性分析

魏智民; 张家鑫; 王雷; 宋川; 王一雯; 冀肖健; 李刚; 黄烽

doi:10.16766/j.cnki.issn.1674-4152.004300

强直性脊柱炎患者功能状态与焦虑抑郁情绪的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.004300

魏智民¹,
张家鑫²,
王雷³,
宋川²,
王一雯²,
冀肖健²,
李刚¹,
黄烽^2, ,

1.
中央军委联合参谋部警卫局卫生保健处，北京 100031
2.
解放军总医院第一医学中心风湿免疫科，北京 100039
3.
空军特色医学中心消化内科，北京 100142

基金项目:

军委后勤保障部卫生局应用基础研究项目 19BJZ41

详细信息

通讯作者:
黄烽，E-mail：fhuang@301hospital.com.cn

中图分类号: R593.23 R749.4
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- 文章访问数: 10
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-25
- 网络出版日期: 2026-03-13

Correlation analysis between functional status and anxiety-depressive emotions in patients with ankylosing spondylitis

1.
Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Beijing 100031, China

摘要

摘要: 目的探讨强直性脊柱炎(AS)患者功能状态与焦虑抑郁情绪之间的关系，及AS临床用药在AS患者不同功能状态中对焦虑抑郁情绪的潜在影响。方法本研究纳入2021年3—6月就诊于解放军总医院第一医学中心风湿免疫科的148例AS患者。使用Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎测量指数(BASMI)评价患者的功能水平，抑郁自评量表(SDS)和焦虑自评量表(SAS)评价患者的情绪状态，探索AS患者功能水平与焦虑抑郁情绪的线性或非线性相关性，并按不同功能状态分组，分析AS常用药物的使用对AS患者合并焦虑抑郁情绪比例的潜在影响。结果 AS患者中存在情绪问题者占比30.41%(45/148)，其中合并焦虑、抑郁者占比分别为14.19%(21/148)和22.97%(34/148)。结果发现AS患者的BASFI与SAS和SDS评分呈显著线性相关(P < 0.001)，而BASMI与SAS和SDS无相关性(P > 0.05)。亚组分析显示，BASFI＜1.5的功能障碍亚组中，使用非甾体抗炎药(NSAIDs)治疗的AS患者合并抑郁情绪的比例更低(P=0.024)，而肿瘤坏死因子拮抗剂、传统合成改善病情抗风湿药和中药的治疗对焦虑情绪影响的差异无统计学意义；药物对SAS的影响差异均无统计学意义。结论 AS患者功能受限与焦虑抑郁情绪之间存在显著相关性。NSAIDs治疗可能改善有功能障碍AS患者的抑郁情绪状态。
- 强直性脊柱炎 /
- 功能受限 /
- 焦虑抑郁 /
- 相关性分析
Abstract: Objective To explore the relationship between functional status and anxiety-depressive emotions in patients with ankylosing spondylitis (AS), and to assess potential influences of clinical medications on anxiety-depressive emotions of AS patients in different functional status. Methods This study included 148 AS patients treated at Outpatient Rheumatology Clinics in the First Medical Center of Chinese PLA General Hospital from March 2021 to June 2021. The Bath ankylosing spondylitis functional index (BASFI) and Bath ankylosing spondylitis metrology index (BASMI) were used to evaluate the functional status, while the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS) were utilized to assess the emotional disorder. Linear or nonlinear correlation between functional status and anxiety-depressive emotions was analyzed, and potential influences of different treatments on proportions of patients accompanied with anxiety-depressive emotions in subgroups based on functional status were investigated. Results Among included AS patients, 30.41% (45/148) were accompanied with emotional disorder, in which proportions of anxiety and depression were 14.19% (21/148) and 22.97% (34/148) respectively. Significant linear correlations were found between BASFI and scores of SAS and SDS (P < 0.001), while the correlation between BASMI and the scores of SAS and SDS was not statistically significant (P > 0.05). In functional limitation subgroup (BASFI < 1.5), AS patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs) exhibited lower proportion of depression than those treated without NSAIDs (P=0.024), whereas impacts of tumor necrosis factor inhibitor, conventional synthetic disease modifying antirheumatic drug, and traditional Chinese medicine on SDS showed no significant difference. The effects of medications on anxiety were statistically non-different. Conclusion There are significant correlations between functional status and anxiety-depressive emotions in AS patients. Treatment with NSAIDs may improve the depressive emotional status of AS patients with functional limitation.
- Ankylosing spondylitis /
- Functional limitation /
- Anxiety-depression /
- Correlation analysis

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图 1 巴斯强直性脊柱炎测量指数与焦虑抑郁水平的限制性立方线条图

Figure 1. Restricted cubic spline of BASFI and scores of SAS and SDS

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表 1 148例强直性脊柱炎患者一般资料

Table 1. Characteristics of 148 AS patients

项目	数值
年龄(x±s，岁)	33.79±8.51
性别(男性/女性，例)	121/27
吸烟[例(%)]	27(18.24)
BMI(x±s)	24.33±3.67
AS评估
BASDAI(x±s)	1.85±1.44
ASDAS(x±s，分)	1.72±0.92
BASFI[M(P₂₅, P₇₅)]	1.00(0.20, 2.00)
BASMI[M(P₂₅, P₇₅)]	1.00(0.00, 2.00)
红细胞沉降率[M(P₂₅, P₇₅)，mm/h]	8.00(4.00, 18.00)
C-反应蛋白[M(P₂₅, P₇₅)，g/L]	3.04(1.00, 11.27)
情绪状态评估(x±s，分)
SAS	39.99±9.48
SDS	42.27±11.96
药物使用[例(%)]
NSASIDs	121(81.76)
TNFi	50(33.78)
csDMARDs	31(20.95)
中药	62(41.89)
注：NSAIDs为非甾体抗炎药(nonsteroidal anti-inflammatory drugs)，TNFi为肿瘤坏死因子拮抗剂(tumor necrosis factor inhibitor)，csDMARDs为传统合成改善病情抗风湿药(conventional synthetic disease modifying antirheumatic drug)。

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表 2 NSAIDs对不同功能状态AS患者合并焦虑情绪的影响

Table 2. Effects of NSAIDs on anxiety in AS patients with different functional status

变量	NSAIDs(-)	NSAIDs(+)	β(95% CI)	P值
全部患者	4/27	14/121	0.75(0.23~2.50)	0.642
功能正常组	1/18	5/76	0.14(-3.81~4.09)	0.695
功能障碍组	3/9	9/45	0.31(0.07~1.41)	0.130
注：全部患者与功能正常组比较，交互作用P=0.591。

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表 3 TNFi对不同功能状态AS患者合并焦虑情绪的影响

Table 3. Effects of TNFi on anxiety in AS patients with different functional status

变量	TNFi(-)	TNFi(+)	β(95% CI)	P值
全部患者	12/98	6/50	0.98(0.34~2.78)	0.966
功能正常组	4/61	1/33	0.45(0.05~4.16)	0.478
功能障碍组	8/37	5/17	1.51(0.41~5.57)	0.535
注：全部患者与功能正常组比较，交互作用P=0.355。

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表 4 csDMARDs对不同功能状态AS患者合并焦虑情绪的影响

Table 4. Effects of csDMARDs on anxiety in AS patients with different functional status

变量	csDMARDs(-)	csDMARDs(+)	β(95% CI)	P值
全部患者	16/117	2/31	0.44(0.09~2.00)	0.286
功能正常组	4/77	1/17	1.14(0.12~10.90)	0.909
功能障碍组	12/40	1/14	0.18(0.02~1.53)	0.116
注：全部患者与功能正常组比较，交互作用P=0.244。

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表 5 中药对不同功能状态AS患者合并焦虑情绪的影响

Table 5. Effects of traditional Chinese medicine on anxiety in AS patients with different functional status

变量	中药(-)	中药(+)	β(95% CI)	P值
全部患者	8/86	10/62	1.88(0.69~5.06)	0.215
功能正常组	2/54	3/40	2.11(0.34~13.25)	0.426
功能障碍组	6/32	7/22	2.02(0.57~7.14)	0.274
注：全部患者与功能正常组比较，交互作用P=0.971。

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表 6 NSAIDs对不同功能状态AS患者合并抑郁情绪的影响

Table 6. Effects of NSAIDs on depression in AS patients with different functional status

变量	NSAIDs(-)	NSAIDs(+)	β(95% CI)	P值
全部患者	11/27	27/121	0.42(0.17~1.01)	0.052
功能正常组	3/18	9/76	0.67(0.16~2.78)	0.583
功能障碍组	8/9	18/45	0.08(0.01~0.72)	0.024
注：全部患者与功能正常组比较，交互作用P=0.114。

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表 7 TNFi对不同功能状态AS患者合并抑郁情绪的影响

Table 7. Effects of TNFi on depression in AS patients with different functional status

变量	TNFi(-)	TNFi(+)	β(95% CI)	P值
全部患者	24/98	14/50	1.20(0.56~2.59)	0.644
功能正常组	6/61	6/33	2.04(0.60~6.91)	0.254
功能障碍组	18/37	8/17	0.94(0.30~2.96)	0.914
注：全部患者与功能正常组比较，交互作用P=0.365。

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表 8 csDMARDs对不同功能状态AS患者合并抑郁情绪的影响

Table 8. Effects of csDMARDs on depression in AS patients with different functional status

变量	csDMARDs(-)	csDMARDs(+)	β(95% CI)	P值
全部患者	29/117	9/31	1.24(0.51~3.00)	0.631
功能正常组	9/77	3/17	1.62(0.39~6.75)	0.508
功能障碍组	20/40	6/14	0.75(0.22~2.56)	0.646
注：全部患者与功能正常组比较，交互作用P=0.423。

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表 9 中药对不同功能状态AS患者合并抑郁情绪的影响

Table 9. Effects of traditional Chinese medicine on depression in AS patients with different functional status

变量	中药(-)	中药(+)	β(95% CI)	P值
全部患者	18/86	20/62	1.80(0.85~3.79)	0.122
功能正常组	6/54	6/40	1.41(0.42~4.75)	0.578
功能障碍组	12/32	14/22	2.92(0.95~8.99)	0.062
注：全部患者与功能正常组比较，交互作用P=0.390。

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