摘要
导言：骨关节炎（OA）是一种世界性的致残性疾病，在老年人中更为常见。虽然焦虑和抑郁障碍在 OA 中很常见，并可能影响治疗的依从性，但这两种障碍仍未得到充分认识和治疗。本研究旨在筛查原发性膝关节 OA 患者的焦虑症和抑郁症，并研究医院焦虑抑郁量表（HADS）评分与不同疾病参数之间的关系：研究招募了 50 名符合原发性膝关节 OA 分类标准的患者，50 名年龄和性别匹配的健康人作为对照组。研究人员询问病史，进行临床检查，并使用视觉模拟量表评估疼痛强度。6分钟步行测试用于功能状态评估，X光膝关节平片根据凯尔格伦和劳伦斯分类系统进行评分。参与者填写了 HADS 问卷：29名患者为女性（58%），21名患者为男性（42%）。OA 患者的 HADS 平均得分明显高于对照组（P = 0.001）。据统计，OA 患者的 HADS-A（焦虑）平均得分明显高于对照组（p < 0.001）。患者焦虑的发生率（44%）高于对照组（10%）（p < 0.001）。在回归分析中，女性性别可分别作为HADS-A和HADS-D（抑郁）的预测因子（β：0.4，0.3；t：3.28，2.2；p = 0.002，0.03；CI：1.3-5.6，0.2-4.4），而膝关节让位可作为HADS-A的预测因子（β：0.34，t：2.8，p = 0.007，CI：0.96-5.87）：本研究结果表明，与对照组相比，原发性膝关节 OA 患者的焦虑水平明显高于抑郁水平。女性性别可被视为HADS-A和HADS-D的预测因子，而膝关节屈曲可被视为HADS-A的预测因子。Introduction: Osteoarthritis (OA) is a worldwide, disabling condition, more prevalent in older people. Although anxiety and depression disorders are common in OA and may affect compliance with treatment, both disorders are still underrecognized and undertreated. The present study aimed to screen for anxiety and depression among patients with primary knee OA, and to study the relationship between Hospital Anxiety and Depression Scale (HADS) score and different disease parameters.
Material and methods: Fifty patients fulfilling primary knee OA classification criteria were recruited for the study, and 50 age- and sex-matched healthy individuals served as a control group. Medical history was taken, clinical examination was done, and pain intensity was assessed using the Visual Analogue Scale. The 6-minute walk test was used for functional status assessment, and plain X-ray knees were scored according to the Kellgren and Lawrence classification system. Participants completed the HADS questionnaire.
Results: Twenty-nine patients were female (58%) and 21 were male (42%). The mean HADS score was significantly higher in OA patients than controls (p = 0.001). The mean HADS-A (Anxiety) score was statistically significantly higher in OA patients than controls (p < 0.001). Anxiety was more frequent in patients (44%) than in controls (10%) (p < 0.001). In regression analysis, female sex could be considered as a predictor for each of HADS-A and HADS-D (Depression) (β: 0.4, 0.3; t: 3.28, 2.2; p = 0.002, 0.03; CI: 1.3-5.6, 0.2-4.4), respectively, while knee giving way was considered as a predictor for HADS-A (β: 0.34, t: 2.8, p = 0.007, CI: 0.96-5.87).
Conclusions: The results of the present study showed that anxiety level rather than depression was significantly higher in patients with primary knee OA than in controls. Female sex could be considered as a predictor for each of HADS-A and HADS-D, while knee giving way was considered as a predictor for HADS-A.
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