新冠疫情期间情绪对非酒精性脂肪性肝病患者血生化指标的影响*

doi:10.3969/j.issn.1672-5069.2023.02.011

摘要/Abstract

摘要： 目的探讨新冠肺炎疫情期间非酒精性脂肪性肝病(NAFLD)患者情绪和肝功能指标的变化。方法 2022年1～6月我科诊治的NAFLD患者28例,常规检测血生化指标,采用问卷调查方法进行抑郁自评量表(PHQ-9)和广泛性焦虑自评量表(GAD-7)评分。结果在疫情封控后,28例NAFLD患者血清丙氨酸氨基转移酶(ALT)和门冬氨酸氨基转移酶(AST)水平分别为(88.6±9.2)U/L和(49.2±3.9)U/L,显著高于疫情封控前【分别为(52.3±4.9)U/L和(31.0±2.7)U/L,P<0.01】,而血清总胆红素、γ-谷氨酰转肽酶(GGT)、血糖和血脂水平无显著性变化(P>0.05);在疫情封控后,NAFLD患者GAD-7评分为(7.9±0.6),显著高于疫情封控前【(5.9±0.5),P<0.05】,PHQ-9评分为(6.9±0.7),显著高于疫情封控前【(5.3±0.5),P<0.05】;在矫正性别和年龄后,NAFLD患者GAD-7评分变化与血清ALT水平升高呈正相关【β=0.033(CI:0.005～0.061),P=0.021】,而与血清AST水平变化无显著相关性【β=0.037(CI:-0.015～0.09),P=0.165】。结论新冠肺炎疫情可能诱发NAFLD患者情绪变化,并可能导致肝功能损伤。重视疫情对NAFLD患者造成的心理影响,需要给予合适的心理疏导和社会支持,可能对NAFLD患者的病情改善有帮助。

关键词: 非酒精性脂肪性肝病, 新冠肺炎, 疫情, 焦虑, 抑郁

Abstract: Objective The aim of this study was to investigate the impact of COVID-19 pandemic on emotions and liver function tests in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 28 patients with NAFLD were encountered in our hospital between January to Jun 2022, and the BMI, liver function tests, blood glucose and blood lipids were obtained and the psychological state was evaluated by using 9-item depression scale of patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). Results At the end of the episode of pandemic in Shanghai, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in 28 patients with NAFLD were (88.6±9.2)U/L and(49.2±3.9)U/L, significantly higher than [(52.3±4.9)U/L and (31.0±2.7)U/L, P<0.01] before the pandemic, while there were no significant differences as respect to total serum bilirubin, serum γ-glutamyltransferase (GGT), blood glucose and blood lipids levels (P>0.05); the GAD-7 score in patients with NAFLD after the pandemic was (7.9±0.6), significantly higher than [(5.9±0.5), P<0.05] before pandemic, and the PHQ-9 score was (6.9±0.7), also significantly higher than [(5.3±0.5), P<0.05] before pandemic; after adjusting for gender and age, the change of GAD-7 score was positively correlated with the elevated serum ALT level in patients with NAFLD[β=0.033(CI:0.005-0.061),P=0.021], but not with serum AST level [β=0.037(CI:-0.015-0.09),P=0.165]. Conclusion The pandemic of COVID-19 could result in the anxiety of patients with NAFLD, which might lead to the liver injury. More mental attention, psychological counseling and social support should be paid to them at the time of hardship.

Key words: Non-alcoholic fatty liver diseases, COVID-19, Pandemic, Anxiety, Depression

方颖, 金家东, 汪芾, 周达. 新冠疫情期间情绪对非酒精性脂肪性肝病患者血生化指标的影响^*[J]. 实用肝脏病杂志, 2023, 26(2): 193-196.

Fang Ying, Jin Jiadong, Wang Fu, et al.. Impact of COVID-19 pandemic on emotions and liver function tests in patients with nonalcoholic fatty liver diseases[J]. Journal of Practical Hepatology, 2023, 26(2): 193-196.

参考文献

[1] Chalasani N, Younossi Z, Lavine JE, et al. The diagnosisand management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology, 2012, 142(7): 1592-1609.
[2] Tanaka N, Aoyama T, Kimura S, et al. Targeting nuclear receptors for the treatment of fatty liver disease. Pharmacol Ther, 2017, 179: 142-157.
[3] Jung JY, Park SK, Oh CM, et al. Non-alcoholic fatty liver disease and its association with depression in Korean general population. J Korean Med Sci, 2019, 34(30): e199.
[4] Choi JM, Chung GE, Kang SJ, et al. Associationbetween anxiety and depression and nonalcoholic fatty liver disease. Front Med (Lausanne), 2021, 7: 585618.
[5] Labenz C, Huber Y, Michel M, et al. Nonalcoholicfatty liver disease increases the risk of anxiety and depression. Hepatol Commun, 2020, 4(9): 1293-1301.
[6] Qiu J, Shen B, Zhao M, et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr, 2020, 33(2): e100213.
[7] 李伟, 张彩迪, 罗金晶, 等. 新型冠状病毒肺炎疫情期间不同人群心理状态的Meta分析. 同济大学学报(医学版), 2022, 41(2): 147-154.
[8] 赵文清, 陈双艺, 胡俊, 等. 新冠疫情防控常态化下上海市徐汇区居民的抑郁、焦虑、失眠症状及其相关因素研究. 精神医学杂志, 2022, 35(1): 55-59.
[9] 季建林, 耿瑞杰. 新冠肺炎疫情对医务工作者心理健康的影响. 中国临床医学, 2022, 29(3): 307-311.
[10] 傅燚, 孙跃喜, 张宸韬, 等. 上海市方舱医院新型冠状病毒肺炎患者心理健康状况调查及影响因素研究. 同济大学学报(医学版), 2022, 43(3): 303-309.
[11] 翟文海, 张琼, 胡卫, 等. 新冠肺炎疫情发生前后中国大学生焦虑症状及相关因素的meta分析. 中国心理卫生杂志, 2022, 36(7): 626-632.
[12] Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med, 2001, 16(9): 606-613.
[13] Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
[14] Zhang YL, Liang W, Chen ZM, et al. Validity and reliability ofpatient health questionnaire-9 and patient health questionnaire-2 to screen for depression among college students in China. Asia-Pacific psychi, 2013, 5(4): 268-275.
[15] Garcia-Campayo J, Zamorano E, Ruiz MA, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes, 2010, 8(1): 8.
[16] Fan JG. Epidemiology of alcoholic and nonalcoholic fatty liver disease in China. J Gastroenterol Hepatol, 2013, 28(Suppl 1): 11-17.
[17] Lee JW, Park SH. Association between depression and nonalcoholic fatty liver disease: Contributions of insulin resistance and inflammation. J Affect Disord, 2021, 278: 259-263.
[18] Gu Y, Zhang W, Hu Y, et al. Association between nonalcoholic fatty liver disease and depression: A systematic review and meta-analysis of observational studies. J Affect Disord, 2022, 301: 8-13.
[19] Noon SL, D'Annibale DA, Schwimmer MH, et al. Incidence ofdepression and anxiety in a cohort of adolescents with nonalcoholic fatty liver disease. J Pediatr Gastroenterol Nutr, 2021, 72(4): 579-583.
[20] Lee K, Otgonsuren M, Younoszai Z, et al. Association of chronic liver disease with depression: apopulation-based study. Psychosomatics, 2013, 54(1): 52-59.
[21] Hui DS, I Azhar E, Madani TA, et al. Thecontinuing 2019-nCoV epidemic threat of novel coronaviruses to global health—The latest 2019 novel coronavirus outbreak in Wuhan, China. In J Infect Dis, 2020, 91: 264-266.
[22] 陶叶婷, 潘勤, 陈光榆, 等. 非酒精性脂肪性肝病患者性格及情绪状态调查. 实用肝脏病杂志, 2017, 20(6): 713-719.
[23] Tomeno W, Kawashima K, Yoneda M, et al. Non-alcoholic fatty liver disease comorbid with major depressive disorder: The pathological features and poor therapeutic efficacy. J Gastroenterol Hepatol, 2015, 30(6): 1009-1014.
[24] Shatri H, Putranto R, Faisal E, et al. Psychotherapy for healthcare provider during COVID-19 pandemic: an evidence based clinical review. Acta Med Indones, 2021, 53(2): 225-232.

新冠疫情期间情绪对非酒精性脂肪性肝病患者血生化指标的影响^*

Impact of COVID-19 pandemic on emotions and liver function tests in patients with nonalcoholic fatty liver diseases

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	魏丽, 刘博, 赵楠, 梁丽君. 恩替卡韦抗病毒治疗慢性乙型肝炎合并非酒精性脂肪性肝病患者病毒学应答情况分析^*[J]. 实用肝脏病杂志, 2023, 26(2): 181-184.
[2]	范明芳, 田瑛, 周倩, 接贵涛, 刘淑芳. 慢性丙型肝炎合并非酒精性脂肪性肝病患者血清RBP4和SREBP-1c水平变化分析^*[J]. 实用肝脏病杂志, 2023, 26(2): 185-188.
[3]	郝蕾, 高卫东, 胡娟娟, 张琳, 邢亚恒. 非酒精性脂肪性肝病患者血清脂联素、维生素D和载脂蛋白B水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(2): 189-192.
[4]	刘岗, 张浩, 胡峻. 非酒精性脂肪性肝病患者血清miR-183-5p和miR-96-5p水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(2): 197-201.
[5]	李潇萌, 吴少玉, 王媛媛. 非酒精性脂肪性肝病合并2型糖尿病患者血清同型半胱氨酸、成纤维细胞生长因子21和核因子-κB水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2023, 26(2): 202-205.
[6]	黄淡霞, 招志辉, 萧月兴, 何艳青. 小檗碱通过调节肠道菌群改善高脂饮食诱导的非酒精性脂肪性肝病大鼠肝组织炎症实验研究^*[J]. 实用肝脏病杂志, 2023, 26(1): 23-26.
[7]	陈凤莲, 朱青蓝, 朱伶俐, 陈国飞. 非酒精性脂肪性肝病患者外周血恒定自然杀伤T细胞和CD4⁺/CD8⁺T细胞活化差异研究^*[J]. 实用肝脏病杂志, 2023, 26(1): 31-34.
[8]	徐伟强, 刘淑萍, 李潇萌. 体检人群非酒精性脂肪性肝病检出率及其危险因素分析^*[J]. 实用肝脏病杂志, 2023, 26(1): 35-38.
[9]	陈怡, 朱友, 周希乔. 甲状腺激素与非酒精性脂肪性肝病研究进展^*[J]. 实用肝脏病杂志, 2023, 26(1): 145-148.
[10]	李向阳, 丁光伟, 靳铭. 恩替卡韦治疗慢性乙型肝炎合并NAFLD患者临床疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(6): 776-779.
[11]	孙峥, 王笑烨, 袁景, 梁丽. 达格列净联合利拉鲁肽治疗非酒精性脂肪性肝病合并2型糖尿病患者短期疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(6): 796-799.
[12]	蔡勇, 李璟, 欧琴. 2型糖尿病合并非酒精性脂肪性肝病患者血清网膜素、视黄醇结合蛋白4和Ⅰ型原胶原氨基端前肽水平及意义分析^*[J]. 实用肝脏病杂志, 2022, 25(6): 800-803.
[13]	孙凌, 杭玮, 邓国忠. 二甲双胍联合吡格列酮治疗非酒精性脂肪性肝病合并2型糖尿病患者疗效研究^*[J]. 实用肝脏病杂志, 2022, 25(6): 804-807.
[14]	王晓华, 曾雅琳, 郭萃蓉. 非酒精性脂肪性肝病进展性肝纤维化患者空腹血糖受损和胰岛素抵抗调查^*[J]. 实用肝脏病杂志, 2022, 25(6): 812-815.
[15]	樊叶, 张喜梅, 张岩. 非酒精性脂肪性肝病患者血清胱抑素C、脂蛋白α和nesfatin-1水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2022, 25(6): 816-819.