论文部分内容阅读
目的:观察以疲劳程度判定老年肿瘤患者是否合并抑郁症的可行性。方法:选取老年肿瘤患者(肿瘤组)232例和未合并肿瘤的老年人(非肿瘤组)196例,分别采用贝克抑郁自评量表和Piper疲劳修订量表对抑郁和疲劳状况进行评估,计算并比较两种方法对抑郁症的诊断敏感度、特异度、阳性预测值、阴性预测值及检出率。采用受试者工作特征曲线(ROC)曲线下面积(AUC)比较两种量表的鉴别诊断效能。结果:非肿瘤组贝克抑郁评分(9.40±1.51)和疲劳度评分(3.80±1.87)均低于肿瘤组(分别为16.80±2.78和7.20±1.69),差异均有统计学意义(t=-3.400、-4.265,P=0.003、0.000)。在肿瘤组中,抑郁的检出率为77.59%(180/232),疲劳的检出率为80.17(186/232),两种量表检出重叠人数为152例,两种量表检出率比较差异无统计学意义(χ2=3.578,P=0.067)。Piper疲劳修订量表诊断抑郁症的灵敏度、特异性、准确率、阳性预测值及阴性预测值分别为0.844(152/180)、0.346(18/52)、94.44(170/180)、0.817(152/186)、0.391(18/46)。贝克抑郁量表与Piper疲劳修订量表的ROC曲线下面积(AUC)均为0.79。结论:老年肿瘤患者存在更严重的抑郁和疲劳状态,以疲劳程度可正确识别84.4%合并抑郁症的老年肿瘤患者,疲劳程度可能会成为判断老年肿瘤患者是否存在抑郁症的一个有价值的线索。
Objective: To observe the feasibility of using fatigue degree to determine whether elderly patients with cancer complicated with depression. Methods: A total of 232 elderly patients with cancer (tumor group) and 196 elderly patients with non-tumor group (non-tumor group) were enrolled in this study. Depression and fatigue were assessed by using the Beck Depression Scale and the Piper Fatigue Revised Scale, respectively The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and detection rate of the two methods were compared. The receiver operating characteristic (ROC) area under the curve (AUC) was used to compare the differential diagnostic efficacy of the two scales. Results: The scores of Baker depression in non-tumor group (9.40 ± 1.51) and fatigue score (3.80 ± 1.87) were significantly lower than those in tumor group (16.80 ± 2.78 and 7.20 ± 1.69 respectively) (t = -3.400 , -4.265, P = 0.003, 0.000). In the tumor group, the detection rate of depression was 77.59% (180/232), the detection rate of fatigue was 80.17 (186/232), and the overlap between the two scales was 152. The two scales were detected The difference was not statistically significant (χ2 = 3.578, P = 0.067). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the Piper fatigue scale in diagnosing depression were 0.844 (152/180), 0.346 (18/52), 94.44 (170/180), 0.817 (152 /186),0.391(18/46). The area under the ROC curve (AUC) for the Beck Depression Scale and the Piper Fatigue Revision Scale were both 0.79. CONCLUSIONS: Elderly patients with cancer have more severe depression and fatigue status. Accurately identifying 84.4% of elderly patients with depression with fatigue degree may be a valuable clue for judging the presence of depression in elderly patients with cancer.