溃疡性结肠炎患者合并焦虑症状的临床相关因素分析

doi:10.3969/j.issn.1004-583X.2026.07.004

摘要/Abstract

摘要：

目的分析溃疡性结肠炎(ulcerative colitis, UC)患者合并焦虑症状的临床相关因素,为早期识别与干预提供依据。方法本研究为回顾性研究。纳入2022年11月-2025年11月河南大学第一附属医院收治的UC患者104例。根据汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)将患者分为焦虑组(HAMA总分≥14分,n=42)和非焦虑组(HAMA总分<14分,n=62)。收集两组临床资料,包括匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评分,血清脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平。通过多因素logistic逐步回归分析、受试者工作特征曲线分析UC患者合并焦虑症状的影响因素。结果两组性别、疾病活动度、病变范围、PSQI评分和血清BDNF水平差异均有统计学意义(P<0.05)。多因素logistic回归分析发现,女性、重度疾病活动度、病变范围为E3型、较高的PSQI评分是UC患者合并焦虑症状的独立危险因素,较高的血清BDNF水平是UC患者合并焦虑症状的独立保护因素(P<0.05)。通过绘制受试者工作特征曲线,PSQI评分、血清BDNF水平均可用于UC患者合并焦虑症状的评估,曲线下面积分别为0.780、0.929(均P<0.05)。结论性别、疾病活动度、病变范围、PSQI评分及血清BDNF水平与UC患者合并焦虑症状有关,临床应对女性、疾病重度活动、病变范围广泛(E3型)、PSQI评分≥8.996分及血清BDNF水平≤14.792 μg/L的患者进行重点关注,必要时启动心理干预。

关键词: 结肠炎, 溃疡性, 焦虑, 疾病活动度, 睡眠障碍

Abstract:

Objective To analyze the clinical factors associated with anxiety symptoms in patients with ulcerative colitis (UC), and to provide evidence for early identification and intervention. Methods This retrospective study included 104 patients with UC admitted to the First Affiliated Hospital of Henan University from November 2022 to November 2025. Based on the Hamilton Anxiety Scale (HAMA), patients were divided into an anxiety group (HAMA total score ≥14, n=42) and a non-anxiety group (HAMA total score <14, n=62). Clinical information were collected for both groups, including the Pittsburgh sleep quality index (PSQI) score and serum brain-derived neurotrophic factor (BDNF) level. Multivariate logistic stepwise regression analysis and receiver operating characteristic (ROC) curve analysis were used to identify factors associated with anxiety symptoms in patients with UC. Results There were statistically significant differences between the two groups in sex, disease activity, lesion extent, PSQI score, and serum BDNF level (P<0.05). Multivariate logistic regression analysis showed that female sex, severe disease activity, lesion extent of E3 type, and higher PSQI score were independent risk factors for anxiety symptoms in patients with UC, whereas higher serum BDNF level was an independent protective factor (P<0.05). ROC curve analysis showed that both PSQI score and serum BDNF level could be used to assess anxiety symptoms in patients with UC, with area under the curve values of 0.780 and 0.929, respectively (both P<0.05). Conclusion Sex, disease activity, lesion extent, PSQI score, and serum BDNF level are associated with anxiety symptoms in patients with UC. Clinically, greater attention should be given to female patients, those with severe disease activity, extensive lesions (E3 type), PSQI score ≥8.996, and serum BDNF level ≤14.792 μg/L, and psychological intervention should be initiated when necessary.

Key words: colitis, ulcerative, anxiety, disease activity, sleep disorders

中图分类号:

R574.62

张志爽, 王凤楠, 魏方圆, 曹振振. 溃疡性结肠炎患者合并焦虑症状的临床相关因素分析[J]. 临床荟萃, 2026, 41(7): 602-607.

Zhang Zhishuang, Wang Fengnan, Wei Fangyuan, Cao Zhenzhen. Clinical factors associated with anxiety symptoms in patients with ulcerative colitis[J]. Clinical Focus, 2026, 41(7): 602-607.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.07.004

https://www.lchc.cn/CN/Y2026/V41/I7/602

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参考文献 23

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项目	焦虑组(n=42)	非焦虑组(n=62)	t/χ²值	P值
性别[例(%)]
男女	16(38.10) 26(61.90)	40(64.52) 22(35.48)	7.033	0.008
年龄(岁)	45.28±8.73	44.05±8.61	0.711	0.479
BMI(kg/m²)	22.15±1.18	21.84±1.37	1.214	0.228
病程(年)	5.22±1.42	4.87±0.97	1.495	0.138
病程中复发次数(次)	2.52±1.13	2.46±1.02	0.282	0.779
吸烟史[例(%)]	5(11.90)	13(20.97)	1.437	0.231
饮酒史[例(%)]	4(9.52)	11(17.74)	1.370	0.242
既往腹部手术史[例(%)]	2(4.76)	3(4.84)	0.202	0.653
婚姻状况[例(%)]
已婚未婚或离异	30(71.43) 12(28.57)	46(74.19) 16(25.81)	0.097	0.755
受教育程度[例(%)]
初中及以下高中及以上	18(42.86) 24(57.14)	20(32.26) 42(67.74)	1.213	0.271
疾病活动度[例(%)]
轻中度重度	19(45.24) 23(54.76)	42(67.74) 20(32.26)	5.229	0.022
肠外表现[例(%)]
关节痛	7(16.67)	8(12.90)	0.287	0.592
口腔溃疡	5(11.90)	6(9.68)	0.131	0.717
病变范围[例(%)]
E1直肠型	5(11.90)	15(24.19)
E2左半结肠型	13(30.95)	28(45.16)	7.500	0.024
E3广泛结肠型	24(57.15)	19(30.65)
PSQI评分(分)	10.85±2.73	7.23±2.15	7.547	<0.01
红细胞沉降率(mm/1 h)	28.52±6.20	26.83±6.59	1.314	0.192
生物制剂使用[例(%)]	8(19.05)	9(14.52)	0.376	0.540
SSRS评分(分)	43.83±7.87	45.08±7.37	0.826	0.411
CRP(mg/L)	24.35±3.87	23.08±3.45	1.753	0.083
Hb(g/L)	117.52±20.33	120.81±16.78	0.900	0.370
BDNF(μg/L)	12.38±2.15	17.24±3.02	8.993	<0.01

项目	焦虑组(n=42)	非焦虑组(n=62)	t/χ²值	P值
性别[例(%)]
男女	16(38.10) 26(61.90)	40(64.52) 22(35.48)	7.033	0.008
年龄(岁)	45.28±8.73	44.05±8.61	0.711	0.479
BMI(kg/m²)	22.15±1.18	21.84±1.37	1.214	0.228
病程(年)	5.22±1.42	4.87±0.97	1.495	0.138
病程中复发次数(次)	2.52±1.13	2.46±1.02	0.282	0.779
吸烟史[例(%)]	5(11.90)	13(20.97)	1.437	0.231
饮酒史[例(%)]	4(9.52)	11(17.74)	1.370	0.242
既往腹部手术史[例(%)]	2(4.76)	3(4.84)	0.202	0.653
婚姻状况[例(%)]
已婚未婚或离异	30(71.43) 12(28.57)	46(74.19) 16(25.81)	0.097	0.755
受教育程度[例(%)]
初中及以下高中及以上	18(42.86) 24(57.14)	20(32.26) 42(67.74)	1.213	0.271
疾病活动度[例(%)]
轻中度重度	19(45.24) 23(54.76)	42(67.74) 20(32.26)	5.229	0.022
肠外表现[例(%)]
关节痛	7(16.67)	8(12.90)	0.287	0.592
口腔溃疡	5(11.90)	6(9.68)	0.131	0.717
病变范围[例(%)]
E1直肠型	5(11.90)	15(24.19)
E2左半结肠型	13(30.95)	28(45.16)	7.500	0.024
E3广泛结肠型	24(57.15)	19(30.65)
PSQI评分(分)	10.85±2.73	7.23±2.15	7.547	<0.01
红细胞沉降率(mm/1 h)	28.52±6.20	26.83±6.59	1.314	0.192
生物制剂使用[例(%)]	8(19.05)	9(14.52)	0.376	0.540
SSRS评分(分)	43.83±7.87	45.08±7.37	0.826	0.411
CRP(mg/L)	24.35±3.87	23.08±3.45	1.753	0.083
Hb(g/L)	117.52±20.33	120.81±16.78	0.900	0.370
BDNF(μg/L)	12.38±2.15	17.24±3.02	8.993	<0.01

变量	回归系数	标准误	Waldχ²值	P值	OR值	95%可信任区间
性别	1.201	0.419	8.214	0.004	3.325	1.462~7.562
疾病活动度	1.410	0.546	6.679	0.010	4.097	1.406~11.938
病变范围	0.684	0.275	6.185	0.013	1.982	1.156~3.398
PSQI评分	1.180	0.390	9.164	0.002	3.255	1.516~6.989
BDNF	-0.311	0.093	11.183	0.001	0.733	0.611~0.879

变量	回归系数	标准误	Waldχ²值	P值	OR值	95%可信任区间
性别	1.201	0.419	8.214	0.004	3.325	1.462~7.562
疾病活动度	1.410	0.546	6.679	0.010	4.097	1.406~11.938
病变范围	0.684	0.275	6.185	0.013	1.982	1.156~3.398
PSQI评分	1.180	0.390	9.164	0.002	3.255	1.516~6.989
BDNF	-0.311	0.093	11.183	0.001	0.733	0.611~0.879

指标	曲线下面积	标准误	P值	95%可信任区间	最佳截断值	敏感度	特异度
PSQI评分	0.780	0.049	<0.01	0.683~0.877	8.996	0.667	0.855
BDNF	0.929	0.025	<0.01	0.880~0.977	14.792	0.786	0.984