围绝经期人群焦虑和抑郁状态与双膦酸盐治疗依从性和骨密度变化的相关性

张爱慕; 刘三微; 施展宏; 周帆

doi:10.16766/j.cnki.issn.1674-4152.004009

围绝经期人群焦虑和抑郁状态与双膦酸盐治疗依从性和骨密度变化的相关性

doi: 10.16766/j.cnki.issn.1674-4152.004009

温州市中心医院妇产科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2024ZL997

温州市基础性医疗卫生科技项目 Y20210357

详细信息

通讯作者:
张爱慕，E-mail：hham2008@126.com

中图分类号: R173.4 R711.75
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出版历程
- 收稿日期: 2024-06-05
- 网络出版日期: 2025-08-14

Correlation analysis of anxiety and depression with bisphosphonate treatment compliance and bone mineral density changes in perimenopausal population

Department of Obstetrics and Gynecology, Wenzhou Central Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的分析围绝经期人群焦虑和抑郁状态与双膦酸盐治疗依从性和骨密度(BMD)变化的相关性，为早期干预该类人群焦虑和抑郁提供依据。方法采用便利抽样法抽取温州市中心医院2022年2月—2024年2月期间诊治的248例围绝经期女性，采用Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)评估研究对象的焦虑抑郁状态，根据结果将其分为焦虑抑郁发生组(SAS评分≥50分和SDS评分≥53分)和未发生组。分析比较2组一般资料、双膦酸盐治疗依从性以及BMD水平，采用多因素logistic回归分析研究影响围绝经期女性焦虑抑郁状态的因素；同时将焦虑抑郁发生组按照SAS、SDS评分分为轻、中、重度，采用Pearson检验分析患者焦虑抑郁评分与双膦酸盐治疗依从性及骨密度变化的相关性。结果完成调查的245例围绝经期女性中有71例发生焦虑抑郁，发生率为28.98%。多因素logistic回归分析显示，高BMI、无配偶、高围绝经期症状严重程度评分均为围绝经期女性发生焦虑抑郁的独立危险因素，无慢性病、用药依从性高、高BMD是围绝经期女性发生焦虑抑郁的独立保护因素。围绝经期女性焦虑评分与双膦酸盐治疗依从性、BMD变化均呈负相关关系。结论围绝经期人群焦虑抑郁发生率较高，且与双膦酸盐治疗依从性和BMD变化呈负相关关系。
- 围绝经期 /
- 焦虑 /
- 抑郁 /
- 双膦酸盐治疗依从性 /
- 骨密度 /
- 相关性
Abstract: Objective To analyze the correlation between anxiety and depression in the perimenopausal population, compliance with bisphosphonate treatment and changes in bone mineral density (BMD), and to provide evidence for early intervention of anxiety and depression in women. Methods A total of 248 perimenopausal women diagnosed and treated in Wenzhou Central Hospital from February 2022 to February 2024 were selected by convenient sampling method, and their anxiety and depression were evaluated by Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS). According to the results, they were divided into an anxiety and depression group (SAS score ≥50 and SDS score ≥53) and a non-anxiety and depression group. The general data, bisphosphonate treatment compliance, and BMD of the two groups were analyzed and compared, and the related factors affecting the patients ' anxiety and depression were analyzed by multivariate logistic regression. At the same time, the anxiety and depression group was divided into mild, moderate, and severe according to the SAS score and SDS score. Pearson test was used to analyze the correlation between anxiety and depression scores and bisphosphonate treatment compliance, and BMD changes in perimenopausal women. Results Among the 245 perimenopausal patients who completed the investigation, 71 cases developed anxiety and depression, with an incidence rate of 28.98%. By multivariate logistic regression analysis, high BMI, no spouse, and high perimenopausal symptom severity score were independent risk factors for anxiety and depression in perimenopausal women, while no chronic disease, high medication compliance, and high BMD were independent protective factors for anxiety and depression in perimenopausal women. Anxiety score of perimenopausal women was negatively correlated with bisphosphonate treatment compliance and BMD changes. Conclusion The incidence of anxiety and depression in the perimenopausal population is high, which is negatively correlated with the compliance of bisphosphonate treatment and the change in BMD.
- Perimenopausal period /
- Anxiety /
- Depression /
- Compliance of bisphosphonate treatment /
- Bone mineral density /
- Correlation

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表 1 2组围绝经期女性一般资料比较

Table 1. Comparison of general data of two groups of perimenopausal women

项目	焦虑抑郁发生组(n=71)	未发生组(n=174)	统计量	P值
年龄(x±s，岁)	51.27±2.15	50.81±2.32	1.484^a	0.140
BMI(x±s)	22.45±5.78	20.31±4.57	2.785^a	0.006
孕产次数(x±s，次)	2.77±0.49	2.69±0.51	1.146^a	0.254
婚姻状况[例(%)]			9.183^b	0.002
有配偶	43(60.56)	138(79.31)
无配偶	28(39.44)	36(20.69)
吸烟史[例(%)]	2(2.82)	5(2.87)	0.159^b	0.690
饮酒史[例(%)]	27(38.03)	54(31.03)	1.114^b	0.291
围绝经期症状严重程度评分(x±s，分)	22.78±6.27	16.52±4.89	7.530^a	< 0.001
运动情况[例(%)]			0.773^c	0.440
< 2次/月	12(16.90)	41(23.56)
1~2次/周	51(71.83)	112(64.37)
≥3次/周	8(11.27)	21(12.07)
收缩压(x±s，mmHg)	133.01±10.36	132.27±11.61	0.489^a	0.625
舒张压(x±s，mmHg)	72.25±8.09	71.64±8.23	0.533^a	0.595
居住地[例(%)]			0.099^b	0.753
农村	21(29.58)	48(27.59)
城镇	50(70.42)	126(72.41)
月经情况[例(%)]			0.648^b	0.723
不规律	51(71.83)	133(75.44)
规律	15(21.13)	32(18.39)
闭经	5(7.04)	9(5.17)
文化程度[例(%)]			0.195^c	0.845
初中及以下	11(15.49)	23(13.22)
高中/中专	41(57.75)	105(60.34)
大专及以上	19(26.76)	46(26.44)
有无慢性病[例(%)]			12.017^b	< 0.001
有	42(59.15)	61(35.06)
无	29(40.85)	113(64.94)
FSH(x±s，IU/L)	53.91±16.34	52.57±12.38	0.622^a	0.535
E2(x±s，pg/mL)	40.19±15.59	39.87±16.62	0.143^a	0.887
LH(x±s，IU/L)	29.67±5.71	29.35±5.42	0.404^a	0.687
注：^a为t值，^b为χ²值，^c为Z值；1 mmHg=0.133 kPa。

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表 2 围绝经期女性焦虑抑郁状态影响因素的logistic回归分析

Table 2. Logistic regression analysis of influencing factors of anxiety and depression in perimenopausal women

变量	B	SE	Waldχ²	P值	OR值	95% CI
BMI	0.115	0.057	4.148	0.042	1.122	1.004~1.254
婚姻状况	1.393	0.574	5.899	0.015	4.029	1.309~12.402
围绝经期症状严重程度评分	0.230	0.053	18.512	< 0.001	1.259	1.134~1.398
有无慢性病	-1.241	0.520	5.704	0.017	0.289	0.104~0.800
用药依从性	-1.218	0.254	23.054	< 0.001	0.296	0.180~0.486
BMD	-2.957	0.559	27.969	< 0.001	0.052	0.017~0.155

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表 3 围绝经期女性焦虑抑郁评分与双膦酸盐治疗依从性和BMD变化的相关性

Table 3. The correlation between anxiety and depression scores in perimenopausal women and the compliance of bisphosphonate treatment and changes in BMD

项目	程度	例数	得分(x±s，分)	双膦酸盐治疗依从性			BMD
项目	程度	例数	得分(x±s，分)	得分(x±s，分)	r值	P值	水平(x±s，g/cm²)	r值	P值
焦虑	轻度	30	54.19±2.25	4.43±1.15	-0.675	< 0.001	-2.05±0.43	-0.478	< 0.001
	中度	28	65.27±2.12	3.24±0.78			-2.48±0.59
	重度	13	75.84±2.39	2.41±0.41			-2.81±0.65
抑郁	轻度	31	58.44±2.46	4.57±1.12	-0.593	< 0.001	-2.02±0.48	-0.370	< 0.001
	中度	27	67.85±2.35	3.27±0.75			-2.51±0.56
	重度	13	76.49±2.41	3.38±0.43			-2.84±0.61

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