Page 38 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第44卷第5期
·626 · Journal of Nanjing Medical University（Natural Sciences） 2024年5月

·临床研究·

袖状胃切除术对青年黑棘皮病患者心理状态和生活质量的影

响和机制探讨

朱翠玲 ，杜 磊 ，王 玥 ，贾许杨 ，黄 秀 ，钱春花 1*
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同济大学附属上海市第十人民医院内分泌与代谢病科，减重外科，上海 200072
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［摘 要］ 目的：评估腹腔镜袖状胃切除术（laparoscopic sleeve gastrectomy，LSG）对青年肥胖黑棘皮病（acanthosis nigricans，
AN）患者的心理和生活质量状态的影响及机制探讨。方法：回顾性收集2020年1月—2022年12月在上海市第十人民医院收
治的行LSG手术的52例青年AN患者临床资料，选取50例健康人作对照组（control，CON）。采用Beck抑郁自评量表⁃Ⅱ评估心
理状态，采用中文版SF⁃36量表对研究对象的生活质量进行评价。检测和计算术前和术后12个月AN患者的人体测量学指标、
糖代谢指标、脂代谢指标、C反应蛋白（C⁃reactive protein，CRP），并进行比较。抑郁症与相关代谢性指标行相关性分析。结果：
AN组患者的术前生活质量评估各维度的得分显著低于CON组（P < 0.05），抑郁症发生率（63.5%）明显高于CON组（P< 0.001），
抑郁程度也明显高于 CON 组（P < 0.001）。AN 组患者术前空腹胰岛素水平、胰岛素抵抗、血脂、CRP水平均明显高于CON组
（P < 0.05）。术后12个月AN组患者随体重下降，血脂、CRP显著下降，其高胰岛素血症和胰岛素抵抗显著改善。同时AN患者的
SF⁃36量表中心理健康评分显著升高，抑郁评分和程度也得到显著改善。患者的抑郁评分与体重指数、胰岛素抵抗、CRP呈正相
关。结论：AN患者的抑郁症与胰岛素抵抗、炎症因子升高密切相关。LSG通过降低体重、改善胰岛素抵抗、炎症状态，有效改善了
AN患者的抑郁状态和生活质量。
［关键词］ 减重手术；腹腔镜袖状胃切除术；肥胖；黑棘皮病；抑郁；生活质量
［中图分类号］ R589 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）05⁃626⁃08
doi：10.7655/NYDXBNSN230887

Effect and mechanism of sleeve gastrectomy on psychological status and quality of life of
young obese patients with acanthosis nigricans

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ZHU Cuiling ，DU Lei ，WANG Yue ，JIA Xuyang ，HUANG Xiu ，QIAN Chunhua 1*
1 Department of Endocrinology and Metabolism，Department of Bariatric Surgery，Shanghai Tenth People’s Hospital，
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Tongji University，School of Medicine，Shanghai 200072，China
［Abstract］ Objective：To evaluate the effect of laparoscopic sleeve gastrectomy（LSG）on the psychological and quality of life of
young obese patients with acanthosis nigricans（AN）and explore the mechanism. Methods：Clinical data of 52 young AN patients who
underwent LSG surgery at Shanghai Tenth People's Hospital from January 2020 to December 2022 were retrospectively collected，and
50 healthy individuals were selected as the control group（CON）. The Beck self⁃rating depression scale⁃Ⅱ was used to evaluate the
psychological status，and the Chinese version of SF⁃36 was used to evaluate the quality of life of the subjects. The anthropometries
parameters，glucose metabolic indicators，lipid metabolism indicators，and C ⁃ reactive protein（CRP）levels of AN patients were
evaluated and calculated before and 12 months after surgery，and compared before and after surgery. Correlation analysis was
performed between depression and related metabolic indicators. Results：The scores of each dimension of quality of life assessment in
the AN group before surgery were significantly lower than those in the CON group（P < 0.05），and the incidence of depression（63.5%）
was significantly higher than that in the CON group（P < 0.001），with a significantly higher severity of depression than the CON group
（P < 0.001）. The levels of fasting insulin，insulin resistance，blood lipids and CRP of the AN group before surgery were significantly
higher than those of the CON group（P < 0.05）. Twelve months after surgery，as the weight of AN patients decreased，blood lipids and

［基金项目］ 上海市卫生健康委员会临床专项研究面上课题（202040170）
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通信作者（Corresponding author），E⁃mail：chqian2003@126.com