摘要
目的分析儿童重症肺炎后发生创伤后应激障碍(Post-Traumatic Stress Disorder,PTSD)的危险因素。方法选取我院在2022年1月~2025年1月收治的120例重症肺炎患儿纳入研究,根据创伤后应激障碍自评量表(post-traumatic stress disorder self-rating scale,PTSD-SS)将患儿分为PTSD组45例(PTSD-SS>50分)及非PTSD组75例(PTSD-SS≤50分)。收集患儿一般资料,通过ROC及多因素Logistic回归分析影响患儿发生PTSD的危险因素。结果PTSD组内向、消极应对患儿人数占比高于非PTSD组,急性生理与慢性健康评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHE-Ⅱ)评分、干扰素-γ(Interferon-gamma,IFN-γ)水平高于非PTSD组,5-羟色胺(5-hydroxytryptamine,5-HT)水平低于非PTSD组(P<0.05);经多因素Logistic回归分析证实,人格特征(内向)、应对方式(消极)、APACHE-Ⅱ评分>44.121分、5-HT<183.542 ng/mL、IFN-γ>7.492 pg/mL均是患儿发生PTSD的危险因素(P<0.05);经ROC曲线分析证实,APACHE-Ⅱ评分、5-HT、IFN-γ可用于预测患儿PTSD的发生,曲线下面积分别为0.827、0.778、0.832(P<0.05)。当联合这3个指标诊断患儿PTSD发生时,曲线下面积达到0.965(P<0.05)。结论人格特征、应对方式、APACHE-Ⅱ评分、5-HT、IFN-γ均是影响重症肺炎患儿发生PTSD的因素,且联合测量能够提升预测精准性,可为临床提供可靠参考依据。
Objective To analyze the risk factors of Post-Traumatic Stress Disorder(PTSD)in children with severe pneumonia.Methods A total of 120 children with severe pneumonia admitted to our hospital from January 2022 to January 2025 were included in the study.According to the Post-traumatic stress disorder self-rating scale(PTSD-SS),the children were divided into PTSD group(45 cases)and non-PTSD group(75 cases).The general data of children were collected,and the risk factors of PTSD in children were analyzed by ROC and multivariate Logistic regression.Results The proportion of children with introversion and negative coping in PTSD group is higher than that in non-depressed group.The scores of acute physiology and chronic health evaluationⅡ(Apache-Ⅱ)and the level of interfer-on-gamma(IFN-γ)are higher than those in non-PTSD group,and the level of 5-hydroxytryptamine(5-HT)is lower than that in non-PTSD group.(P<0.05).Logistic regression analysis showed that personality(introversion),coping style(negative),APACHE-Ⅱ score>44.121,5-HT<183.542 ng/ml,IFN-γ>7.492 pg/ml were all risk factors for PTSD in children(P<0.05).Receiver Operating Characteristic(ROC)curve analysis confirmed that APACHE-Ⅱ score,5-HT,IFN-ycould be used to predict the occurrence of PTSD in children,and the areas under the curve were 0.827,0.778,0.832,respectively(P<0.05).When combined,the three parameters could yield a diagnostic area under the curve of 0.965(P<0.05).Conclusion Personality characteristics,coping style,APACHE-Ⅱ score,5-HT and IFN-γ are all factors influencing the occurrence of PTSD in children with severe pneumonia.Combined measurement can improve the prediction accuracy and provide reliable reference for clinic.
作者
杜冰菁
杨俊
DU Bingjing;YANG Jun(School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,China)
出处
《国际精神病学杂志》
2025年第5期1576-1579,1598,共5页
Journal Of International Psychiatry
基金
贵州省卫生健康委科学技术基金项目(编号:gzwjkj2020-2-023)。
关键词
儿童重症肺炎
创伤后应激障碍
急性生理与慢性健康评分Ⅱ
5-羟色胺
干扰素-Γ
Severe pneumonia in children
Post-Traumatic stress disorder
Acute physiology and chronic health evaluationⅡ
5-hydroxytryptamine
Interferon-gamma
