杨祺+邹晓鸿+陈良

摘 要 目的：调查社区代谢综合征患者心理健康状况，为全科医生开展心理干预提供依据。方法：2015年12月采取随机抽样方法选取凌云街道社区卫生服务中心代谢综合征管理库中120例患者进行自编基本情况问卷调查，用症状自评量表（SCL-90）进行心理健康状况评分，根据量表结果评估心理健康状况。结果：除了偏执和精神病性两个因子差异无统计学意义外，SCL-90其余各因子差异均有统计学意义（P<0.05）。代谢综合征患者的躯体化、强迫症状、抑郁、焦虑、敌对、恐怖等因子分明显高于全国常模，而患者人际关系敏感因子分则明显低于常模。结论：社区代谢综合征患者易出现心理健康问题，全科医生应重视其心理问题的早期筛查与干预。

关键词 代谢综合征 心理健康 问卷

中图分类号：R589 文献标志码：A 文章编号：1006-1533（2016）22-0047-02

Assessment of the mental health status of the patients with metabolic syndrome in the community

YANG Qi， ZHOU Xiaohong， CHEN Liang（Lingyun Community Health Service Center of Xuhui District， Shanghai 200237， China）

ABSTRACT Objective： To investigate the mental health status of patients with metabolic syndrome in the community to provide the basis for general practitioners to carry out psychological intervention. Methods： With the random sampling method， 120 patients with metabolic syndrome were selected in the management library of Lingyun Community Health Service Center and investigated with the self compiled basic situation questionnaire in Dec. 2015. The mental health status score was evaluated with the symptom checklist（SCL-90）. According to the questionnaire results the mental health status was evaluated. Results： Except there were no statistically significant differences in the two factors of paranoia and psychosis， the rest factors of the SCL-90 were statistically significant（P<0.05）. The scores of the factors such as somatic symptoms， obsessive-compulsive symptoms， depression， anxiety， hostility and terror in the patients with metabolic syndrome were significantly higher than those in the national norm， and the score of the factor of patient interpersonal sensitivity was significantly lower than that in the national norm. Conclusion： The community patients with metabolic syndrome are more likely to have mental health problems， and the general practitioners should pay more attention to the early screening and intervention of their psychological problems.

KEY WORDS metabolic syndrome； mental health； questionnaire

代谢综合征（MS）是一种集糖、脂代谢紊乱、肥胖、胰岛素抵抗和高血压于一体的临床综合征[1]。目前认为MS是遗传基因和环境、社会因素综合作用所致的身心疾病。而现代应激理论同样认为，慢性应激会使机体处于适应不良，从而导致身心疾病[2]。本研究通过量表调查，评估社区代谢综合征患者的心理健康状况，旨在为全科医生开展代谢综合征的综合管理提供循证依据。

1 对象与方法

1.1 对象

于2015年12月采取随机抽样的方法选取上海市凌云街道社区卫生服务中心代谢综合征管理库中120例患者进行问卷调查，收回有效问卷111份，有效回收率为92.5%。其中男性39例（35.14%），女性72例（64.86%）；平均年龄为（63.59±4.83）岁。患者纳入标准参照2004年中华医学会糖尿病分会（CDS）诊断标准[3]，①超重或肥胖：体质指数（BMI）≥25.0 kg/m2；②高血糖：空腹血糖（FPG）≥6.1 mmol/L，及（或）餐后2 h血糖（2 hPG）≥7.8 mmol/L，或（及）诊断为糖尿病者；③高血压：收缩压/舒张压（SBP/DBP）≥140/90 mmHg，及（或）己确认为高血压病治疗者；④血脂紊乱：空腹血甘油三酯（TG）≥1.7 mmol/L，或空腹血高密度脂蛋白胆固醇（HDL-C）：男性<0.9 mmol/L，女性<1.0 mmol/L）。……