甲狀腺乳頭狀癌與負(fù)面情緒的關(guān)聯(lián)性研究

作者單位:

1.南昌大學(xué)第二附屬醫(yī)院 甲狀腺外科，江西 南昌 330006;2.美國(guó)威斯康星大學(xué)麥迪遜分校文理學(xué)院，威斯康星 麥迪遜 WI53706

作者簡(jiǎn)介:

王流歡，南昌大學(xué)第二附屬醫(yī)院住院醫(yī)師，主要從事甲狀腺疾病方面的研究（李思睿為共同第一作者）。

基金項(xiàng)目:

國(guó)家自然科學(xué)基金資助項(xiàng)目（82204879，82360572）；江西省自然科學(xué)基金資助項(xiàng)目（2024BAB206053）。

Analysis of association between papillary thyroid carcinoma and negative emotions

Author:

WANG Liuhuan

Department of Thyroid Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang330006, China
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LI Sirui

College of Letters & Science, University of Wisconsin-Madison, Madison, WI 53706, USA
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ZENG Liqin

Department of Thyroid Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang330006, China
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XIA Chen

Department of Thyroid Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang330006, China
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Affiliation:

1.Department of Thyroid Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang330006, China;2.College of Letters & Science, University of Wisconsin-Madison, Madison, WI 53706, USA

摘要:

背景與目的 由于甲狀腺乳頭狀癌通常預(yù)后良好，導(dǎo)致對(duì)甲狀腺乳頭狀癌患者心理狀況的研究相對(duì)較少。然而，有動(dòng)物實(shí)驗(yàn)研究顯示，甲狀腺乳頭狀癌與負(fù)面情緒有一定的關(guān)系，可能對(duì)疾病的預(yù)后造成不良影響。因此，本研究通過(guò)焦慮和抑郁兩個(gè)方面探討甲狀腺乳頭狀癌與負(fù)面情緒的關(guān)系，以期了解兩者的關(guān)聯(lián)性，為臨床與科研提供信息。方法 選取2021年6月—2022年4月于南昌大學(xué)第二附屬醫(yī)院甲狀腺外科就診及術(shù)后確診為甲狀腺乳頭狀癌患者（觀察組），并選取同一時(shí)期無(wú)甲狀腺相關(guān)疾病史、無(wú)甲狀腺手術(shù)的健康自愿者為對(duì)照組。針對(duì)研究對(duì)象近1年內(nèi)的情緒狀態(tài)，采用一般情況調(diào)查表、焦慮自評(píng)量表（SAS）、抑郁自評(píng)量表（SDS）對(duì)研究對(duì)象進(jìn)行調(diào)查。并采用多變量Logistic回歸分析焦慮和抑郁情緒與甲狀腺乳頭狀癌發(fā)生風(fēng)險(xiǎn)之間的關(guān)系。結(jié)果 將SAS分為4個(gè)部分比較，觀察組與對(duì)照組的運(yùn)動(dòng)性緊張?jiān)u分差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.496），但觀察組的心理情緒、神經(jīng)功能紊亂、軀體癥狀評(píng)分以及SAS總評(píng)分均明顯高于對(duì)照組（均P<0.05）；將SDS分為4個(gè)部分比較，兩組的心理情緒和精神運(yùn)動(dòng)評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義（均P>0.05），但觀察組的軀體障礙、心理障礙評(píng)分以及SDS總評(píng)分均明顯高于對(duì)照組（均P<0.05）。SAS 20個(gè)條目的多元Logistic回歸分析顯示，焦慮、驚恐、發(fā)瘋、手足顫抖、軀體疼痛、手足刺痛、心悸、惡夢(mèng)、睡眠障礙評(píng)分與甲狀腺乳頭狀癌的風(fēng)險(xiǎn)有關(guān)；SDS 20個(gè)條目的多元Logistic回歸分析顯示，軀體障礙和心理障礙評(píng)分與甲狀腺乳頭狀癌的風(fēng)險(xiǎn)有關(guān)。結(jié)論 負(fù)面情緒與甲狀腺乳頭狀癌的發(fā)生發(fā)展有一定關(guān)聯(lián)，且二者之間可能相互影響，因此，對(duì)于健康人群或甲狀腺乳頭狀癌患者的心理狀態(tài)都應(yīng)加以重視。負(fù)面情緒與甲狀腺乳頭狀癌之間關(guān)聯(lián)的機(jī)制仍需繼續(xù)探索。

Abstract:

Background and Aims Papillary thyroid carcinoma (PTC) generally has a good prognosis, leading to relatively limited research on the psychological status of PTC patients. However, animal studies have shown that PTC is associated with negative emotions, which may adversely affect the prognosis of the disease. Therefore, this study was performed to explore the relationship between PTC and negative emotions, focusing on anxiety and depression, to understand their association and provide information for clinical practice and research.Methods Patients diagnosed with PTC after surgery in the Department of Thyroid Surgery at the Second Affiliated Hospital of Nanchang University from June 2021 to April 2022 were selected as the observation group. Healthy volunteers without a history of thyroid disease or thyroid surgery during the same period were selected as the control group. The emotional status of the subjects in the past year was assessed using a general questionnaire, the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). Multivariable Logistic regression was used to analyze the connection of anxiety and depression to the risk of developing PTC.Results Comparing the four components of SAS, there was no significant difference in the motor tension scores between the observation group and the control group (P=0.496). However, the observation group had significantly higher scores in psychological emotions, neurofunctional disorders, somatic symptoms, and the total SAS score compared to the control group (all P<0.05). Comparing the four components of SDS, there were no significant differences in psychological emotions and psychomotor scores between the two groups (both P>0.05). However, the observation group had significantly higher scores in somatic disorders, psychological disorders, and the total SDS score compared to the control group (all P<0.05). Multivariable Logistic regression analysis of the 20 items of SAS showed that anxiety, panic, insanity, tremors, somatic pain, numbness in hands and feet, palpitations, nightmares, and sleep disturbances were associated with the risk of PTC. Multivariable Logistic regression analysis of the 20 items of SDS indicated that somatic and psychological disorder scores were related to the risk of PTC.Conclusion Negative emotions are associated with the occurrence and development of PTC, and there may be mutual influences between them. Therefore, attention should be given to the psychological well-being of both healthy individuals and PTC patients. The mechanisms underlying the association between negative emotions and PTC require further exploration.

王流歡,李思睿,曾麗琴,夏晨,呂云霞.甲狀腺乳頭狀癌與負(fù)面情緒的關(guān)聯(lián)性研究[J].中國(guó)普通外科雜志,2024,33(11):1813-1824.
DOI:10.7659/j. issn.1005-6947.2024.11.008

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