广西医学

目的探讨肺继发恶性肿瘤患者的抑郁发展轨迹，并分析不同抑郁发展轨迹的影响因素。方法选取75例肺继发恶性肿瘤患者作为研究对象，收集患者的一般资料、临床资料，采用汉密尔顿抑郁量表评估患者出院时及出院后3个月、6个月、9个月、12个月的抑郁状态，采用组基轨迹模型描述不同的抑郁发展轨迹，采用多因素Logistic回归模型分析影响抑郁发展轨迹的相关因素。结果最终确定3条抑郁发展轨迹，分别为抑郁低危组（45.33%）、抑郁风险组（30.67%）、抑郁高危组（24.00%）。3组患者的年龄、文化程度、病程、原发肿瘤直径、治疗前Karnofsky功能状态（KPS）量表评分，以及血清白细胞介素6、C反应蛋白（CRP）、LDL⁃C、HDL⁃C水平比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，与抑郁低危组相比，年龄较大、原发肿瘤直径较大、治疗前KPS量表评分较低、血清LDL⁃C水平较高的肺继发恶性肿瘤患者被归属于抑郁风险组的可能性更大（P<0.05）；病程较长、治疗前KPS量表评分较低及血清白细胞介素6、CRP 水平较高的肺继发恶性肿瘤患者被归属于抑郁高危组的可能性更大（P<0.05）。结论肺继发恶性肿瘤患者存在不同的抑郁发展轨迹，受患者年龄、病程、原发肿瘤直径、KPS量表评分、炎症因子水平及脂质代谢的影响。

Objective To explore the development track of depression in patients with secondary malignant tumors of lung, and to analyze the influencing factors for different development tracks of depression. Methods A total of 75 patients with secondary malignant tumors of lung were selected as the research subjects. The general data, clinical data of patients were collected. The Hamilton Depression Scale was adopted to evaluate depression status of patients after discharge (at discharge, and 3, 6, 9, and 12 months after discharge). Group⁃based trajectory model was employed to describe different development tracks of depression. Multivariate Logistic regression model was used to analyze relevant factors affecting development track of depression. Results A total of 3 development tracks of depression were eventually determined, containing low⁃risk depression group (45.33%), depressive risk group (30.67%), or high⁃risk depression group (24.00%), respectively. There were statistically significant differences in age, educational level, disease course, primary tumor diameter, pre⁃treatment Karnofsky Performance Status (KPS) scale score, and levels of serum interleukin 6, C⁃reactive protein (CRP), LDL⁃C, HDL⁃C between patients of the three groups (P<0.05). The results of multivariate Logistic regression analysis revealed that compared with the low⁃risk depression group, patients with secondary malignant tumors of lung who were older, had greater primary tumor diameter, lower pre⁃treatment KPS scale score, and higher serum LDL⁃C level were more likely to be classified into the depressive risk group (P<0.05); however, patients with secondary malignant tumors of lung who had a longer disease course, a lower pre⁃treatment KPS scale score, and higher levels of serum interleukin 6 and CRP were more likely to be classified into the high⁃risk depression group (P<0.05). Conclusion Patients with secondary malignant tumors of lung have different development tracks of depression, which are affected by age, disease course, primary tumor diameter, KPS scale score, and inflammatory factor level and lipid metabolism.