中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 12
Dec.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(12): 2581-2585

Association between corneal Kayser-Fleischer ring grading and the degree of anxiety-depression in patients with Wilson’s disease

DOI: 10.12449/JCH251220

  • Department of Ophthalmology，The First Affiliated Hospital of Anhui University of Chinese Medicine，Hefei 230001，China

Research funding:

National Natural Science Foundation of China（Joint Fund for Regional Innovation and Development） (U22A20366)

More Information
  • Corresponding author: CHEN Yi， chenyi@azyfy.com （ORCID： 0009-0004-4568-9144）
  • Received Date: 2025-07-14
  • Accepted Date: 2025-09-11
  • Published Date: 2025-12-25
    Abstract
  •   Objective  To investigate the impact of different grades of corneal Kayser-Fleischer （K-F） ring on the severity of anxiety and depression in patients with Wilson’s disease （WD）.  Methods  A total of 107 patients with WD who received consultation in Department of Ophthalmology， The First Affiliated Hospital of Anhui University of Chinese Medicine， from August 2012 to February 2020 were enrolled， and a slit-lamp microscope was used to determine the grade of corneal K-F ring （grades 0 — 4）. The patients were instructed to complete Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale （HAMD） assessments， and the correlation between K-F ring grade and the scores of the two scales was analyzed， as well as the differences in the scores of the two scales between the patients with different K-F ring grades. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test or the Dunnett’s T3 test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Bonferroni method was used for further comparison between two groups. The Spearman correlation analysis was used to investigate the correlation between K-F ring grade and HAMA/HAMD score.  Results  Among the 107 patients with WD， the patients with grade 0 K-F ring accounted for the lowest proportion of 4.6% （5/107）， while the patients with grade 4 K-F ring accounted for the highest proportion of 41.1% （44/107）， and the patients with grade 1 K-F ring， grade 2 K-F ring， and grade 3 K-F ring accounted for 16.8% （18/107）， 22.4% （24/107）， and 14.9% （16/107）， respectively. HAMA and HAMD scores tended to increase with the increase in K-F ring grade （F=16.340 and 12.760， both P <0.001）. The Spearman correlation analysis showed that K-F ring grade was positively correlated with HAMA and HAMD scores （r=0.528 9 and 0.480 1， both P<0.01）.  Conclusion  There is a certain correlation between corneal K-F ring grading and HAMD/HAMA scores， which can partially reflect the severity of anxiety and depression in patients. Therefore， clinicians should emphasize K-F ring examination and its association with clinical symptoms.

     

    • FullText(HTML)
  • loading
    • References(25)
  • [1]
    ROSENCRANTZ R, SCHILSKY M. Wilson disease: Pathogenesis and clinical considerations in diagnosis and treatment[J]. Semin Liver Dis, 2011, 31( 3): 245- 259. DOI: 10.1055/s-0031-1286056.
    [2]
    BANDMANN O, WEISS KH, KALER SG. Wilson’s disease and other neurological copper disorders[J]. Lancet Neurol, 2015, 14( 1): 103- 113. DOI: 10.1016/S1474-4422(14)70190-5.
    [3]
    LUCENA-VALERA A, RUZ-ZAFRA P, AMPUERO J. Wilson’s disease: Overview[J]. Med Clin(Barc), 2023, 160( 6): 261- 267. DOI: 10.1016/j.medcli.2022.12.016.
    [4]
    XIE JJ, WU ZY. Wilson’s disease in China[J]. Neurosci Bull, 2017, 33( 3): 323- 330. DOI: 10.1007/s12264-017-0107-4.
    [5]
    TELINIUS N, OTT P, SANDAHL T, et al. Scheimpflug imaging of the Danish cohort of patients with Wilson disease[J]. Cornea, 2019, 38( 8): 998- 1002. DOI: 10.1097/ico.0000000000001959.
    [6]
    ROBERTS EA, SCHILSKY ML. Diagnosis and treatment of Wilson disease: An update[J]. Hepatology, 2008, 47( 6): 2089- 2111. DOI: 10.1002/hep.22261.
    [7]
    CHEN FF, HU FY, CAO XL, et al. Response to D-penicillamine treatment in patients with Wilson’s disease and different degree of Kayser-Fleischer ring[J]. J Pract Hepatol, 2024, 27( 1): 145- 147. DOI: 10.3969/j.issn.1672-5069.2024.01.037.

    陈芬芬, 胡风云, 曹晓莉, 等. 肝豆状核变性患者角膜K-F环与临床病情程度关系探讨[J]. 实用肝脏病杂志, 2024, 27( 1): 145- 147. DOI: 10.3969/j.issn.1672-5069.2024.01.037.
    [8]
    HAN XQ. Application of anxiety and depression in general hospital[J]. Chin Arch Otolaryngol Head Neck Surg, 2014, 21( 11): 583- 584. DOI: 10.16066/j.1672-7002.2014.11.008.

    韩学青. 焦虑抑郁量表在综合医院的应用[J]. 中国耳鼻咽喉头颈外科, 2014, 21( 11): 583- 584. DOI: 10.16066/j.1672-7002.2014.11.008.
    [9]
    AKIL M, BREWER GJ. Psychiatric and behavioral abnormalities in Wilson’s[J]. Adv Neurol, 1995, 65: 171- 178.
    [10]
    Inherited Metabolic Liver Disease Collaboration Group, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the diagnosis and treatment of hepatolenticular degeneration(2022 edition)[J]. Chin J Hepatol, 2022, 30( 1): 9- 20. DOI: 10.3760/cma.j.cn501113-20211217-00603.

    中华医学会肝病学分会遗传代谢性肝病协作组. 肝豆状核变性诊疗指南(2022年版)[J]. 中华肝脏病杂志, 2022, 30( 1): 9- 20. DOI: 10.3760/cma.j.cn501113-20211217-00603.
    [11]
    QU J. Optical Theory and Methods[M]. 2nd Edition. Beijing: People’s Medical Publishing House, 2011: 40- 41.

    瞿佳. 眼视光学理论和方法[M]. 2版. 北京: 人民卫生出版社, 2011: 40- 41.
    [12]
    HU JY, ZHOU ZH, WANG X, et al. The effect of long-term copper removal therapy on the grading changes of K-F ring in the cornea of patients with hepatic steatosis[C]// The 18th National Neurology Academic Conference of the Chinese Medical Association. Chengdu, 2015: 703.

    胡纪源, 周志华, 王训, 等. 长期驱铜治疗对肝豆状核变性角膜K-F环分级变化的影响[C]// 中华医学会第十八次全国神经病学学术会议论文集. 成都, 2015: 703.
    [13]
    HAMILTON M. The assessment of anxiety states by rating[J]. Br J Med Psychol, 1959, 32( 1): 50- 55. DOI: 10.1111/j.2044-8341.1959.tb00467.x.
    [14]
    HAMILTON M. A rating scale for depression[J]. J Neurol Neurosurg Psychiatry, 1960, 23( 1): 56- 62. DOI: 10.1136/jnnp.23.1.56.
    [15]
    XIA B. A case of hepatolenticular degeneration with ocular symptoms as the first symptom[J]. Chin J Ophthalmol Otorhinolaryngol, 2019, 19( 5): 361- 362. DOI: 10.14166/j.issn.1671-2420.2019.05.018.

    夏冰. 以眼部症状首发的肝豆状核变性患者1例[J]. 中国眼耳鼻喉科杂志, 2019, 19( 5): 361- 362. DOI: 10.14166/j.issn.1671-2420.2019.05.018.
    [16]
    YANG YL, YANG WM, WANG H, et al. Correlation between muscle tension, clinical characteristics, and traditional Chinese medicine syndromes in patients with Wilson disease based on digital muscle function assessment system myoton PRO[J]. Chin J Exp Tradit Med Formulae, 2025, 31( 15): 147- 154. DOI: 10.13422/j.cnki.syfjx.20241896.

    杨玉龙, 杨文明, 汪瀚, 等. 基于数字化肌肉功能评估系统 Myoton PRO探讨肝豆状核变性患者肌张力与临床特征及中医证型的相关性[J]. 中国实验方剂学杂志, 2025, 31( 15): 147- 154. DOI: 10.13422/j.cnki.syfjx.20241896.
    [17]
    ZHAO LQ, XU S, LIN H. Clinical characteristics and misdiagnosis analysis of 24 cases of mental disorders caused by hepatolenticular degeneration[J]. Aerosp Med, 2010, 21( 2): 167- 168. DOI: 10.3969/j.issn.2095-1434.2010.02.019.

    赵立琼, 徐曙, 林汉. 24例肝豆状核变性所致精神障碍的临床特点与误诊分析[J]. 航空航天医药, 2010, 21( 2): 167- 168. DOI: 10.3969/j.issn.2095-1434.2010.02.019.
    [18]
    ZHANG LY. Analysis of the results of self-rating anxiety and depression scale in 164 gastroscopy subjects[J]. Contemp Med, 2010, 16( 6): 44- 45. DOI: 10.3969/j.issn.1009-4393.2010.06.030.

    张兰英. 焦虑抑郁量表评定164例胃镜检查者的结果分析[J]. 当代医学, 2010, 16( 6): 44- 45. DOI: 10.3969/j.issn.1009-4393.2010.06.030.
    [19]
    WALTER G, LYNDON B. Depression in hepatolenticular degeneration(wikon’s disease)[J]. Aust N Z J Psychiatry, 1997, 31( 6): 880- 882. DOI: 10.3109/00048679709065517.
    [20]
    CAI YL, XU SH, YANG RM, et al. Anxiety and depression in patients with hepatolenticular degeneration[J]. Chin J Clin Psychol, 2000, 8( 1): 46- 47. DOI: 10.16128/j.cnki.1005-3611.2000.01.016.

    蔡永亮, 许圣弘, 杨任民, 等. 肝豆状核变性患者的焦虑、抑郁情绪调查[J]. 中国临床心理学杂志, 2000, 8( 1): 46- 47. DOI: 10.16128/j.cnki.1005-3611.2000.01.016.
    [21]
    FENU M, LIGGI M, DEMELIA E, et al. Kayser-Fleischer ring in Wilson’s disease: A cohort study[J]. Eur J Intern Med, 2012, 23( 6): e150- e156. DOI: 10.1016/j.ejim.2012.04.005.
    [22]
    XU LH. Correlation between Kayser-fleischer ring grades and clinical materials in 320 patients with hepatolenticular degeneration[D]. Hefei: Anhui University of Chinese Medicine, 2020.

    徐柳慧. 320例肝豆状核变性患者角膜K-F环分级与临床相关性研究[D]. 合肥: 安徽中医药大学, 2020.
    [23]
    KANG LL, ZONG ZF, DONG K, et al. Effects of resveratrol on mental symptoms and corneal K-F ring in patients with Wilson’s disease[J]. Clin J Med Off, 2024, 52( 6): 627- 630. DOI: 10.16680/j.1671-3826.2024.06.21.

    康丽利, 宗志峰, 董魁, 等. 白藜芦醇对肝豆状核变性患者精神症状、角膜K-F环影响[J]. 临床军医杂志, 2024, 52( 6): 627- 630. DOI: 10.16680/j.1671-3826.2024.06.21.
    [24]
    PANCHERI P, PICARDI A, PASQUINI M, et al. Psychopathological dimensions of depression: A factor study of the 17-item Hamilton depression rating scale in unipolar depressed outpatients[J]. J Affect Disord, 2002, 68( 1): 41- 47. DOI: 10.1016/s0165-0327(00)00328-1.
    [25]
    HE W, YANG YL, YANG WM, et al. Correlation between Kayser-Fleischer ring grading and cognitive function in Wilson’s disease[J]. J Clin Hepatol, 2025, 41( 6): 1150- 1155. DOI: 10.12449/JCH250622.

    何伟, 杨玉龙, 杨文明, 等. 肝豆状核变性K-F环分级与认知功能的相关性分析[J]. 临床肝胆病杂志, 2025, 41( 6): 1150- 1155. DOI: 10.12449/JCH250622.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (35) PDF downloads(16) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return