Abstract:

Objective　To analyze the prevalence and risk factors of emotional disorders in patients with anal cryptitis (AC). Methods　Three hundred and twenty outpatients and inpatients with AC treated at Xi 'an Hospital of Traditional Chinese Medicine from January 2021 to January 2024 were selected as the study objects. All the patients were evaluated by Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). According to the occurrence of emotional abnormalities, the patients with emotional abnormalities were set as an emotional abnormality group, including 55 males and 71 females whose body mass index was (25.10±1.39) kg/m², and the patients without emotional abnormalities a non-emotional abnormality group, including 89 males and 105 females whose body mass index was (24.88±1.41) kg/m². All the patients' baseline data were statistically analyzed. The relationship of anxiety and depression with intestinal flora was analyzed by bivariate correlation Pearson. Binary logistic regression was used to analyze the risk factors of emotional abnormalities in the patients with AC, and a nomogram was constructed. t, non-parameter Mann-Whitney U, and χ² tests were used. Results　The scores of SAS and SDS in the emotional abnormality group were higher than those in the non-emotional abnormality group [(68.66±5.82) vs. (52.87±3.59) and (69.18±5.03) vs. (53.62±3.65)], with statistical differences (t=30.02 and 32.03; both P<0.05). The levels of Lactobacillus, Enterococcus, and Bifidobacterium in the emotional abnormality group were lower than those in the non-emotional abnormality group [(6.67±1.02) logN/g vs. (8.28±1.26) logN/g, (6.75±1.32) logN/g vs. (7.88±1.09) logN/g, and (7.11±1.13) logN/g vs. (8.02±1.04) logN/g], with statistical differences (t=12.01, 8.33, and 7.39; all P<0.05). The scores of SAS and SDS were negatively correlated with the levels of Lactobacillus, Enterococcus, and Bifidobacterium (all r<0; all P<0.05). The disease course in the emotional abnormality group was longer than that in the non-emotional abnormality group (P<0.05); the scores of Numeric Pain Rating Scale (NRS) and Insomnia Severity Index (ISI) and the proportions of the patients with concomitant diseases and the patients who did not took the primary treatment in the emotional abnormality group were higher than those in the non-emotional abnormality group (all P<0.05). The scores of NRS and ISI and concomitant diseases were the risk factors of emotional abnormalities in the patients with AC (all OR>1; all P<0.05); the levels of Lactobacillus, Enterococcus, and Bifidobacterium were the protective factors of of emotional abnormalities in the patients with AC (all OR<1; all P<0.05). Bootstrap was used to verify the nomogram model; the internal verification was carried out through the modeling group; the results showed that the C-index value was 0.944, and the calibration curve was in good agreement with the ideal curve; the area under the curve (AUC) was 0.917 (95%CI 0.869-0.965, P<0.001). Conclusions　The levels of intestinal flora in patients with AC is closely related to the occurrence of anxiety and depression. The scores of NRS and ISI and concomitant diseases are closely related to the occurrence of emotional abnormalities in patients with AC.

Key words:

Anal cryptitis, Emotional abnormalities, Prevalence, Risk factors

摘要：

目的　分析肛隐窝炎（AC）患者合并情志异常的患病率及危险因素。方法　选择2021年1月至2024年1月西安市中医医院门诊及住院的320例AC患者作为研究对象。患者均接受焦虑［焦虑自评量表（SAS）］、抑郁［抑郁自评量表（SDS）］及肠道菌群检测；经SAS、SDS量表评估，将126例合并情志异常者分为情志异常组［男55例，女71例，体重指数（25.10±1.39）kg/m²］，194例未合并情志异常者分为非情志异常组［男89例，女105例，体重指数（24.88±1.41）kg/m²］；统计患者基线资料，采用双变量相关性Pearson分析焦虑、抑郁与肠道菌群的关系；采用二元logistics回归分析AC患者合并情志异常的危险因素并构建列线图。采用t检验、非参数Mann-Whitney U检验、χ²检验。结果　情志异常组SAS、SDS评分均高于非情志异常组［（68.66±5.82）分比（52.87±3.59）分、（69.18±5.03）分比（53.62±3.65）分］，差异均有统计学意义（t=30.02、32.03，均P<0.05）；情志异常组乳酸杆菌、肠球菌、双歧杆菌水平均低于非情志异常组［（6.67±1.02）logN/g比（8.28±1.26）logN/g、（6.75±1.32）logN/g比（7.88±1.09）logN/g、（7.11±1.13）logN/g比（8.02±1.04）logN/g］，差异均有统计学意义（t=12.01、8.33、7.39，均P<0.05）；SAS、SDS与乳酸杆菌、肠球菌、双歧杆菌水平均呈负相关（均r<0，均P<0.05）；情志异常组病程长于非情志异常组，疼痛数字评分量表（NRS）、失眠严重程度指数量表（ISI）得分均高于非情志异常组，合并伴随疾病、非初次治疗患者占比均高于非情志异常组（均P<0.05）；NRS、ISI评分高、合并伴随疾病均是AC患者合并情志异常的危险因素（均OR>1，均P<0.05）；乳酸杆菌、肠球菌、双歧杆菌水平高均是AC患者合并情志异常的保护因素（均OR<1，均P<0.05）；使用Bootstrap法对列线图模型进行验证，结果显示，C-index值分别为0.944，校正曲线均与理想曲线拟合反应良好；曲线下面积（AUC）为0.917（95%CI 0.869～0.965，P<0.001）。结论　AC患者肠道菌群水平与焦虑、抑郁的发生密切相关，NRS、ISI、合并伴随疾病与AC患者伴情志异常的发生密切相关。

关键词:

肛隐窝炎, 情志异常, 患病率, 危险因素