非酒精性脂肪性肝病患者性格及情绪状态调查

doi:10.3969/j.issn.1672-5069.2017.06.019

摘要/Abstract

摘要： 目的调查非酒精性脂肪性肝病（NAFLD）患者性格类型和情绪状态的变化。方法对319例体检成人和64例剔除了NAFLD后的其他肝病患者（慢性乙型肝炎占89.1%）进行肝脏受控衰减参数（CAP）和肝硬度（LSM）及血清转氨酶测定,采用A型行为类型问卷（TABP）、9条病人健康问卷（PHQ-9）和7条广泛性焦虑量表（GAD-7）评估研究对象的性格特点和情绪状态。结果在319例体检者中,剔除29例,健康人93例,NAFLD 197例（轻度脂肪肝88例,中重度脂肪肝109例;非肥胖62例,肥胖135例）;无肝纤维化240例,肝纤维化57例,肝硬化22例;在188例肝功能化验者中,转氨酶正常118例,转氨酶升高70例。在NAFLD组,TABP中时间匆忙感和竞争/敌意（TH/CH）评分为（25.97± 6.81）分,显著高于健康人[（23.41± 6.09）分,P<0.05],与其他肝病组[（25.73± 7.41）分]比无显著性差异（P>0.05）;NAFLD组A型性格占比为39.1%,显著高于健康人（24.7%,P<0.05）,与其他肝病组（46.9%）比无显著性差异（P>0.05）;NAFLD组轻度及以上抑郁情绪占比为62.4%,轻度及以上焦虑情绪占比为51.3%,均显著高于健康人（分别为33.3%和10.8%,P均<0.05）,与其他肝病组（分别为56.3%和42.2%）比无显著差异（P均>0.05）;肝硬化组轻度及以上抑郁情绪占比为86.4%,轻度及以上焦虑情绪占比为68.2%,均显著高于肝纤维化组（分别为49.1%和40.4%）或无肝纤维化组（分别为48.8%和33.3%,P均<0.05）;非肥胖NAFLD组A型性格占比为51.6%,显著高于肥胖NAFLD组（33.3%,P<0.05）;血清转氨酶升高组A型性格占比为47.1%,轻度及以上抑郁情绪占比为64.3%,轻度及以上焦虑情绪占比为54.3%,均显著高于转氨酶正常组（分别为29.7%、44.9%和34.7%,P均<0.05）。结论 NAFLD患者存在显著的性格和情绪异常,非肥胖的NAFLD患者更容易出现A型性格,值得关注。

关键词: 非酒精性脂肪性肝病, A型性格, 抑郁, 焦虑

Abstract: 【Abstract】 Objective To investigate the changes of personality, emotional states in patients with nonalcoholic fatty liver diseases（NAFLD）. Methods319adults taking physical examination, 64patients with liver diseases except NAFLD（57of them were with chronic hepatitis B, CHB） were recruited to complete the controlled attenuation parameter （CAP）, liver stiffness measurement （LSM）, serum aminotransferase tests. Type A behavior pattern scale（TABP）, 9-item patient health questionnaire （PHQ-9）, 7-item generalized anxiety disorder scale（GAD-7） were used to evaluate their personality traits, emotional states. Results Out of319adults, 29cases were ruled out, and the rests were found to be healthy people （n=93）, NAFLD （n=197）. Out of197with NAFLD, 88were with mild, 109with moderate to severe NAFLD;62were non-obese, 135obese;240cases were fibrosis-free, 57with fibrosis, 22with cirrhosis;Out of319, 188took liver function test, 118of them were found with normal alanine aminotransferase（ALT）, and70cases being with elevated ALT. Time hurry（TH）, competitive, hostility（CH） scores by TABP in NAFLD group was25.97±6.81, significantly higher than in healthy people（23.41±6.09, P0.05）; No significant difference was found as respect to TH/CH scores between NAFLD group, other liver diseases group （25.73±7.41, P0.05）;39.1% of cases in NAFLD group were with type A personality, significantly higher than in healthy people（24.7%, P0.05）;No significant difference was found as for type A personality between NAFLD group, other liver diseases group（46.9%, P0.05）;In NAFLD group, 62.4% cases were with mild or severe depressive mood, 51.3% cases with mild or severe anxious mood, both significantly higher than in healthy people（33.3%, 10.8%, respectively, P0.05）;No significant difference was found between NAFLD group, other liver diseases group as respect to the above emotional states （56.3%, 42.2% in the latter, P0.05）;In cirrhosis group, 86.4% were with mild or severe depressive mood, and68.2% with mild or severe anxious mood, both significantly higher than in liver fibrosis group（49.1%, 40.4%, respectively） or in fibrosis-free group （48.8%, 33.3%, respectively, P0.05）;51.6% cases in non-obese NAFLD group were with type A personality, significantly higher than that in obese NAFLD group（33.3%, P0.05）;47.1% cases were with type A personality, 64.3% with mild or severe depressive mood, and54.3% with mild or severe anxious mood in elevated ALT group, all significantly higher than those in normal ALT group（29.7%, 44.9%, 34.7%, respectively, P0.05）. Conclusion Our findings show than NAFLD patients have emotional problems such as personality changes, depression, anxiety, which validates further investigations

Key words: Nonalcoholic fatty liver disease, Type A personality, Depression, Anxiety

陶叶婷, 潘勤, 陈光榆, 颜士岩, 陈源文, 范建高. 非酒精性脂肪性肝病患者性格及情绪状态调查[J]. 实用肝脏病杂志, 2017, 20(6): 713-719.

Tao Yeting,Pan Qin,Chen Guangyu. Personality and emotional states in patients with nonalcoholic fatty liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(6): 713-719.

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