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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2021年02期

页码:

189-194

栏目:

呼吸道传染病与心理卫生

出版日期:

2021-04-20

文章信息/Info

Title:

Impact of COVID-19 on COPD patients'symptom control and mental health

作者:

吕卓瑶¹ 王 浩¹ 庞先琼² 刘雪梅³ 潘 英⁴ 陈小菊⁵ 蒋德雄⁶ 文富强¹

610041 成都,四川大学华西医院呼吸与危重症医学科/生物治疗国家重点实验室呼吸病学研究室¹ 637200 西充,西充县人民医院呼吸与危重症科² 610041 成都,四川大学华西医院中西医结合科³ 641301 资阳,资阳市第一人民医院呼吸与危重症医学科⁴ 637000 南充,川北医学院附属医院呼吸与危重症医学科⁵ 635000 达州,达州市中心医院呼吸与危重症医学科⁶

Author(s):

Lyu Zhuoyao¹;  Wang Hao¹;  Pang Xianqiong²;  Liu Xuemei³;  Pan Ying⁴;  Chen Xiaoju⁵;  Wen Fuqiang¹.

¹Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China; ²Department of Respiratory and Critical Care Medicine, Xichong County People's Hospital, Xichong 637200, China; ³Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University, Chengdu 610041, China; ⁴Department of Respiratory and Critical Care Medicine, The First People's Hospita of Ziyang, Ziyang 642301, China; ⁵Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China; ⁶Department of Respiratory and Critical Care Medicine, Dazhou Central Hospital, Dazhou 635000, China.

关键词:

肺疾病; 慢性阻塞性;  新型冠状病毒疫情;  呼吸系统症状;  心理应激

Keywords:

Chronic obstructive pulmonary disease;  COVID-19;  Respiratory symptoms;  Psychological stress

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2021.02.011

摘要:

目的 了解新型冠状病毒(新冠)疫情对慢性阻塞性肺疾病(COPD)患者病情控制及心理状态的影响。方法 以四川省内多家医疗机构的396例COPD患者作为研究对象。采集其基本人口学信息,肺功能指标,新冠肺炎疫情相关生活史,疫情前(稳定期时)及疫情期间COPD评估量表(CAT)和改良英国医学研究学会呼吸困难指数(mMRC)评分,事件冲击量表(IES-R)和凯斯勒心理量表6项(K6)评分。对收集到的数据进行配对t检验、线性回归等统计分析。结果 获得有效问卷220份。所有患者均无新冠暴露史,但超过一半的患者(126/220,57.3%)表示受到了疫情影响,以日常生活受影响最常见(85/220,38.6%),部分患者就医及用药也受到了影响。呼吸系统症状方面,患者的CAT评分和mMRC评分在疫情前和疫情期间没有明显差异。心理状况方面, IES-R和K6评分显示:IES-R警觉性量表大于0分的患者有178人(178/220,80.9%); GOLD C/D组患者IES-R各项评分及K6评分均高于GOLD A/B组患者。多因素分析结果提示,对IES-R评分可能有影响的因素包括GOLD ABCD分组、隔离措施、药物使用情况以及呼吸道症状。而K6主要受到用药及呼吸道症状的影响。结论 新冠疫情期间,对于无暴露史的COPD患者,虽然其呼吸系统症状不受疫情影响,但部分患者表现出对新冠疫情的应激性心理,并且GOLD C/D组患者受影响更为明显。提示医务工作者在疫情常态化期间,要注意公共卫生事件对COPD患者心理状况的影响,并予以引导及治疗。

Abstract:

Objective To explore the impact of Coronavirus Disease 2019(COVID-19)on chronic obstructive pulmonary disease(COPD)patients'symptom control and mental health. Methods Recruited 396 confirmed COPD patients from multiple hospitals in Sichuan. Collected relevant data, including patients'demographics, data relative to COVID-19, pulmonary functional tests'results, mMRC and CAT before and during COVID-19 breakout, the Kessler Psychological Distress Scale 6(K6)and Impact of Event Scale, revised version(IES-R). Paired t test and linear regression were applied. Results 220 questionnaires were validated and were included in the analysis. None of them got exposure history to COVID-19. More than half of the patients(126/220,57.3%)admitted that COVID-19 had influenced them to some degree, and impact on daily life was the most common(85/220, 38.6%). For respiratory symptoms, there was no significance difference between pre COVID-19 period and COVID-19 outbreak period on both mMRC and CAT score. For mental health, 178 patients scored over 0 on hyperarousal subscale(178/220,80.9%), and patients in GOLD group C/D scored higher on all scales than patients in group A/B, In multivariate analysis, GOLD group ABCD, quarantine strictness, drug usage and respiratory symptoms may have impacts on IES-R score. And K6 was mainly affected by drug usage and respiratory symptoms. Conclusion Respiratory system symptoms of COPD patients without severe acute respiratory syndrome coronavirus 2 contact history were not affected by COVID-19 pandemic. Small number of patients showed psychological stress to COVID-19, and the higher GOLD group rating they got, the more obvious stress they had, which could be a sign for health care worker that attentions are needed for COPD patients under regular COVID-19 prevention and control.

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备注/Memo

备注/Memo:

基金项目: 四川大学华西医院1.3.5卓越高端人才项目(ZYGD18006); 卓越交叉项目(ZYJC18012) 四川省卫健委普及应用项目(20PJ042)
通信作者: 文富强, Email: wenfuqiang@scu.edu.cn

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更新日期/Last Update: 2021-04-20