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摘要:
目的 系统评价中国HIV/AIDS患者的焦虑检出情况。 方法 检索建库至2022年3月有关中国HIV/AIDS患者焦虑检出率的横断面研究，完成文献筛选及质量评价后，采用R 4.4.1软件进行Meta分析。 结果 共纳入文献65篇，研究对象31 303例，合并后中国HIV/AIDS患者焦虑检出率为33.04%(95% CI: 29.73%~36.36%)；亚组分析结果显示，中国不同地区、不同评价量表、不同感染途径、不同研究人群HIV/AIDS患者焦虑检出率的差异均有统计学意义(均P＜0.05)；对不同研究特征进行分组比较，获得社会/家人/朋友支持(OR=0.739 4, 95% CI: 0.683 9~0.799 5，P＜0.01)是HIV/AIDS患者焦虑症状的保护因素。 结论 中国HIV/AIDS患者焦虑检出率较高，建议加强对HIV/AIDS患者心理健康状态的早期评估与干预，改善HIV/AIDS患者的焦虑状态。 Abstract:Objective To systematically evaluate the prevalence of anxiety among HIV/AIDS patients in China. Methods Cross-sectional studies on the anxiety of HIV/AIDS patients in China were searched from the establishment of the database to March 2022. After literature screening and quality evaluation, a meta-analysis was carried out by R 4.4.1 software. Results A total of 65 articles were included, with 31 303 subjects. The prevalence of anxiety among HIV/AIDS patients in China was 33.04% (95% CI: 29.73%-36.36%). The results of subgroup analysis showed that there were statistically significant differences in anxiety among HIV/AIDS patients in different regions, evaluation scales, infection routes and study population (all P < 0.05). At the same time, social/family/friends support (OR=0.739 4, 95% CI: 0.683 9-0.799 5, P < 0.01) was a protective factor for anxiety symptoms in HIV/AIDS patients. Conclusions The prevalence of anxiety among HIV/AIDS patients is high in China. It is suggested that the early evaluation and intervention of mental health status of HIV/AIDS patients should be strengthened to improve the anxiety state of patients with HIV/AIDS. -
Key words:
- HIV/AIDS /
- Anxiety /
- Rate of detection /
- Meta-analysis
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图 2 中国HIV/AIDS患者焦虑检出率森林图
Figure 2. Forest plot of the prevalence of anxiety among HIV/AIDS patients in China
表 1 纳入文献的基本情况和AHRQ评分
Table 1. Characteristics of the included studies and AHRQ scores
研究Studys 研究时间Study year 研究地区Study regions 年龄/岁Age/year 男性数量No. male 样本量Sample size 筛查量表Screeening scales AHRQ得分/分AHRQ scores/points 熊君2022 Jun xiong 2022 NA 西部Western 65.29±7.57 372 498 GAD-7 7 白少丽2021 Shaoli bai 2021 2016.1—2017.12 华北North China NA 435 444 HAD-A 8 王晨冉2021 Chenran wang 2021 NA 西部Western 41.39±9.84 0 150 HAD-A 7 朱晗2021 Han zhu 2021 2019.9—2020.9 华东East China 63.89±6.02 541 624 HAD-A 9 朱文娇2020 Wenjiao zhu 2020 2014.1—2015.12 多中心Multicenter 41.38±6.86 193 255 HAD-A 6 谢天2020 Tian xie 2020 2018.1—2018.2 西部Western 62.70±7.50 209 301 GAD-7 8 靳娟2020 Juan jin 2020 2016.7—2019.1 西部Western 33.00±10.10 269 269 SCL-90 8 朱丽华2020 Lihua zhu 2020 2019.2—2019.7 华中Central China NA 173 210 HAD-A 7 张彬2020 Bin zhang 2020 2019.6 西部Western 65.30±7.60 372 498 GAD-7 7 陈学军2020 Xuejun chen 2020 2017.1—2018.5 西部Western 41.32±9.81 168 278 SAS 7 黄江秀2020 Jiangxiu huang 2020 2017.7—2019.1 华南South China 48.30±12.20 108 120 SAS 7 石义容2019 Yirong shi 2019 2017.1—2017.6 华南South China NA 209 219 HAD-A 7 田波2019 Bo tian 2019 2016.10—2017.3 西部Western 37.83±10.58 35 54 HAD-A 7 胡艳霞2019 Yanxia hu 2019 2017.3—2017.12 华东East China NA 127 127 SCL-90 7 孙盈红2019 Yinghong sun 2019 2014.9—2015.11 多中心Multicenter NA 3 096 3 892 HAD-A 7 杜秀华2019 Xiuhua du 2019 2017.1—2018.9 华东East China 40.50±6.70 23 42 SAS 7 王丽娟2019 Lijuan wang 2019 2017.1—2017.3 华北North China NA 284 197 SAS 7 黄嘉月2018 Jiayue huang 2018 2016.10—2017.3 西部Western 46.60±14.50 NA 125 SAS 8 冯世艳2018 Shiyan feng 2018 2017.1—2017.4 东北Northeast China NA 289 309 HAD-A 7 崔伟峰2018 Weifeng cui 2018 2014.1—2015.1 华中Central China 49.07±7.82 103 279 SAS 7 赵方2017 Fang zhao 2017 2016.1—2016.3 华南South China 31.45±7.02 557 594 HAD-A 7 杨雨薇2017 Yuwei yang 2017 2013.1—2014.6 华东East China 42.43±10.55 199 298 SAS 8 江艳2017 Yan jiang 2017 2015.6—2015.12 华中Central China 35.60±11.50 284 360 SAS 7 杨瑛2017 Ying yang 2017 2016 华东East China 39.60±12.60 278 294 SAS 9 任晓华2017 Xiaohua ren 2017 2015.12—2016.1 华中Central China 35.27±11.65 409 504 SAS 9 周凯2017 Kai zhou 2017 2016.5—2016.8 华南South China 33.48±10.24 170 184 GAD-7 7 柳英2017 Ying liu 2017 2013.3—2014.9 华中Central China 29.00±8.00 321 321 GAD-7 7 赵玲2017 Ling zhao 2017 2016.1—2016.2 西部Western 41.70±11.50 291 410 GAD-7 7 陈淑怡2016 Shuyi chen 2016 2007.9—2008.9 华南South China 34.50±7.10 280 339 SCID I/P 9 罗亦娟2015 Yijuan luo 2015 2014.5—2014.11 华南South China 33.60±8.10 320 353 SCL-90 7 程旭2014 Xu cheng 2014 2013.7—2013.12 华东East China 28.37±4.94 64 64 SAS 7 姚慧洁2014 Huijie yao 2014 NA 华东East China NA 131 136 SAS 7 郑连雪2011 Lianxue zheng 2011 NA 华中Central China NA 104 160 SAS 7 潘承恩2010 Chengen pan 2010 2008.1—2008.12 华东East China NA 209 254 SAS 7 李保刚2008 Baogang li 2008 2008.1—2008.4 西部Western 36.29±6.46 58 95 SAS 6 王迎春2010 Yingchun wang 2010 NA 西部Western NA NA 44 SAS 6 吕金伟2014 Jinwei lv 2014 2012 华东East China 27.30±8.50 162 162 SAS 6 陈涛2018 Tao chen 2018 2015.5 西部Western NA 251 412 SAS 7 孙伟铭2014 Weiming sun 2014 2013.5—2013.12 华东East China 28.26±4.82 65 65 SAS 6 刘云慧2015 Yunhui liu 2015 2013.5—2013.12 华北North China 34.95±10.52 76 76 GAD-7 6 李雁凌2016 Yanling li 2016 2014.1—2014.6 华北North China NA 82 118 HAD-A 7 齐钢桥2020 Gangqiao qi 2020 2014.7—2016.12 华东East China 33.60±13.50 165 202 GAD-7 8 冯理智2020 Lizhi feng 2020 2016.1—2016.12 华南South China 32.60±9.40 180 200 HAD-A 6 高美霞2021 Meixia gao 2021 2014.1—2015.12 华东East China 32.28±9.09 1 468 1 468 HAD-A 7 罗淑星2021 Shuxing luo 2021 2015.6—2019.2 西部Western NA 634 634 SAS 6 邱阳阳2014 Yangyang qiu 2014 2013.3—2014.2 华中Central China 32.78±10.82 341 370 GAD-7 6 王毅2019 Yi wang 2019 2015.9—2017.6 西部Western 20.65±2.27 356 356 SAS 7 刘云2019 Yun liu 2019 2017.6—2017.12 华东East China 37.88±13.73 354 396 HAMA 6 王毅2018 Yi wang 2018 2015.9—2017.6 西部Western NA 350 350 SAS 7 王毅2019 Yi wang 2019 2015.9—2017.6 西部Western 21(19, 23) 362 362 SAS 7 杨梓杰2021 Zijie yang 2021 2019.11—2020.9 华南South China 31.82±8.21 NA 263 GAD-7 7 Yile Wu 2015 2013.4—2013.7 华东East China 31.40±9.20 184 184 SAS 7 Ni Wang 2021 NA 多中心Multicenter 38.00±11.70 3 193 4 091 HAD-A 7 王慧莹2017 Yinghui wang 2017 2015.12—2016.1 华中Central China 35.27±11.65 409 504 SAS 7 Dongfang Wang 2022 2019.3—2019.9 华中Central China 33.01±9.93 484 533 GAD-7 6 Jun Tao 2016 2013.3—2015.5 华北North China 28(25, 32) 364 364 HAD-A 6 Jiaojiao Ren 2018 2013.3—2013.8 东北Northeast China NA 227 237 SAS 7 Rui Luo 2021 2013.3—2014.9 华中Central China NA 197 197 GAD-7 7 Jinghua Li 2015 2013.7—2013.10 西部Western NA 321 321 GAD-7 7 Yunxiang Huang 2018 2013.3—2014.9 华中Central China 28(24, 36) 376 410 GAD-7 7 Xiaojie Huang 2018 NA 多中心Multicenter 37.60±11.70 3 204 4 103 HAD-A 7 Wei Hua 2021 2014.7—2015.4 华北North China 35.00±11.00 532 543 HAD-A 7 Shuyu Han 2020 2017.4—2017.9 多中心Multicenter 55.50±7.90 306 434 GAD-7 7 Jiayu Han 2020 2018.11—2019.2 西部Western 63.00±7.20 375 529 GAD-7 7 I. Chan 2007 NA 华南South China NA NA 118 HAD-A 7 注：AHRQ，医疗保健研究与质量局；NA, 未获得; GAD-7, 广泛性焦虑障碍量表; HAD-A, 医院焦虑与抑郁量表; SCL-90, 症状自评量表; SAS, 焦虑自评表; SCID I/P, DSM-IV-TR轴I障碍用临床定式检查; HAMA, 汉密尔顿焦虑量表。
Note: AHRQ, Agency for Healthcare Research and Quality; NA, not available; GAD-7, generalized anxiexy sisorde-7 Scale; HAD-A, hospital anxiety and depression scale- anxiety; SCL-90, symptom check list 90; SAS, self-rating anxiety scale; SCID I/P, structured clinical interview for DSM-IV axis I disorders-patient edition; HAMA, Hamilton anxiety scal.
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表 2 中国HIV/AIDS患者焦虑检出率的亚组分析
Table 2. A subgroup analysis of the prevalence of anxiety among HIV/AIDS patients in China
亚组Subgroups 研究数量No. of study 焦虑检出率Anxiety detection rate (95% CI) 异质性Heterogeneity I2/% P值value 全人群Total 65 0.330 4(0.297 3~0.363 6) 97.0 < 0.01 研究地区Study region 西部Western China 18 0.315 4(0.241 9~0.388 9) 98.0 < 0.01 华东East China 14 0.371 7(0.291 6~0.451 8) 97.5 < 0.01 华中Central China 11 0.331 3(0.244 6~0.418 1) 95.9 < 0.01 华南South China 9 0.360 4(0.292 2~0.428 6) 89.9 < 0.01 华北North China 6 0.339 0(0.288 1~0.389 9) 78.7 < 0.01 多中心Multicenter 5 0.276 2(0.268 4~0.284 0) 0.0 0.42 东北Northeast China 2 0.2 729(0.032 8~0.510 9) 97.8 < 0.01 评价量表Evaluation scales SAS 26 0.278 9(0.226 9~0.330 9) 95.2 < 0.01 HAD-A 18 0.344 2(0.305 1~0.383 4) 94.3 < 0.01 GAD-7 16 0.385 1(0.312 7~0.457 9) 97.4 < 0.01 SCL-90 3 0.380 5(0.311 7~0.449 4) 75.1 0.02 感染途径Infection routes 同性途径感染Homosexual transmission route 7 0.390 9(0.239 7~0.542 2) 97.8 < 0.01 异性途径感染Heterosexual transmission route 7 0.398 8(0.224 6~0.572 9) 97.2 < 0.01 血液途径感染Bloodborne transmission route 5 0.239 6(0.145 6~0.333 6) 67.7 0.01 静脉注射途径感染Intravenous injection Transmission route 5 0.301 3(0.144 9~0.457 6) 51.3 0.08 研究人群Study population 普通HIV/AIDS患者General HIV/AIDS patients 40 0.343 4(0.290 6~0.396 1) 99.0 < 0.01 MSM群体MSM population 15 0.317 1(0.258 4~0.375 8) 96.2 < 0.01 老年人群(≥50岁) Elderly population (≥50 years old) 5 0.346 8(0.220 9~0.472 7) 98.8 < 0.01 新诊断HIV/AIDS患者Newly diagnosed HIV/AIDS patients 5 0.411 4(0.332 5~0.490 3) 89.3 < 0.01 注：SAS, 焦虑自评表; HAD-A, 医院焦虑与抑郁量表; GAD-7, 广泛性焦虑障碍量表; SCL-90, 症状自评量表。
Note: SAS, self-rating anxiety scale; HAD-A, hospital anxiety and depression scale- anxiety; GAD-7, generalized anxiexy sisorde-7 scale; SCL-90, symptom check list 90.
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表 3 中国不同特征HIV/AIDS患者焦虑检出关系的Meta分析结果
Table 3. Meta-analyses of the association of characteristics and anxiety among HIV/AIDS patients in China
研究特征Study characteristics 研究数量No. of study OR 异质性Heterogeneity OR值value (95% CI) P值value I2/% P值value 社会/家人/朋友支持Social/Family/Friend Support 是Yes 6 0.739 4(0.683 9~0.799 5) < 0.01 44.6 0.10 否No 疾病阶段Disease stages HIV 3 0.806 2(0.584 0~1.113 0) 0.19 0.0 0.66 AIDS 抗病毒治疗Antiviral therapy 是Yes 3 0.940 6(0.707 6~1.250 3) 0.67 88.8 < 0.01 否No CD4+T淋巴细胞计数/mm3 CD4+T cell counts /mm3 ≤200 9 1.123 9(0.972 7~1.298 7) 0.11 70.7 < 0.01 ＞200
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