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[1]高 瞻,尹 燕,晏 妮,等.慢性阻塞性肺疾病并发焦虑抑郁患者临床特征及风险评估[J].中华肺部疾病杂志,2022,(05):625-629.[doi:10.3877/cma.j.issn.1674-6902.2022.05.003]
　Gao Zhan,Yin Yan,Yan Ni,et al.Clinical characteristics and risk assessment of COPD patients with anxiety and depression[J].,2022,(05):625-629.[doi:10.3877/cma.j.issn.1674-6902.2022.05.003]
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慢性阻塞性肺疾病并发焦虑抑郁患者临床特征及风险评估(PDF)

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

卷:
期数:
2022年05期
页码:
625-629
栏目:
论著
出版日期:
2022-10-20

文章信息/Info

Title:
Clinical characteristics and risk assessment of COPD patients with anxiety and depression
作者:
高 瞻; 尹 燕; 晏 妮; 董俊康; 蒋云秋; 张明周; 王关嵩; 龙 舟; 魏征华
400037 重庆,陆军(第三)军医大学第二附属医院呼吸疾病研究所
Author(s):
Gao Zhan;  Yin Yan;  Yan Ni;  Dong Junkang;  Jiang Yunqiu;  Zhang Mingzhou;  Wang Guansong;  Long Zhou;  Wei Zhenghua.
Research Institute of Respiratory Diseases, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
关键词:
肺疾病; 慢性阻塞性;  焦虑/抑郁;  临床特征;  危险因素
Keywords:
Chronic obstructive pulmonary disease;  Anxiety/Depression;  Clinical characteristics;  Risk factors
分类号:
R563
DOI:
10.3877/cma.j.issn.1674-6902.2022.05.003
摘要:
目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)并发焦虑抑郁的危险因素,对COPD并发焦虑抑郁进行风险评估。 方法 选取2016年9月至2020年12月我院门诊和住院纳入的COPD患者295例为对象,根据汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA),分成COPD组及COPD并发焦虑抑郁组。比较两组的临床特征,对COPD并发焦虑抑郁患者行单因素分析、多因素Logistic回归分析,筛选出COPD并发焦虑抑郁患者的危险因素,进行风险评估。结果 295例COPD患者中,焦虑/抑郁者131例(44.4%),其中并发焦虑者111例(37.6%),并发抑郁者104例(35.2%),同时焦虑抑郁者有84例(28.5%)。COPD并发焦虑抑郁组mMRC评分、CAT评分、病程高于无焦虑抑郁者。而FEV1%pred较无发焦虑抑郁组低,差异有统计学意义(P<0.05)。两组患者性别构成、年龄、吸烟、学历、年治疗费用、过去1年是否急性加重等差异无统计学意义。以COPD并发焦虑抑郁为因变量,有统计学差异的变量(mMRC评分、CAT评分、FEV1%pred、病程)为自变量,分别行单因素逻辑回归,显示变量与COPD并发焦虑抑郁有关(P<0.05)。CAT评分(OR=1.074,P<0.05)、FEV1%pred(OR=0.981,P<0.05)是COPD并发焦虑抑郁的危险因素。结论 COPD并发焦虑抑郁患者的FEV1%pred低,mMRC评分、CAT评分高。CAT评分、FEV1%pred是COPD并发焦虑抑郁的危险因素。对CAT评分高、FEV1%pred低的COPD患者风险较高,进行筛查,为预测COPD并发焦虑抑郁患者提供预警,早发现、诊断及治疗,从而提高COPD患者的疗效及其预后。
Abstract:
Objective To investigate the risk factors of chronic obstructive pulmonary disease(COPD)patients with anxiety and depression, and to evaluate the risk of COPD patients with anxiety and depression. Methods 294 patients with COPD from Respiratory and Critical Care Medical Center of Xinqiao Hospital of Army Medical University from September 2016 to December 2020 were selected as the research objects for cross-sectional study. According to Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA), they were divided into COPD group and COPD combined with anxiety and depression group. The clinical characteristics of the two groups were compared. Univariate analysis and multivariate logistic regression analysis were performed for COPD patients with anxiety and depression, and the independent risk factors of COPD patients with anxiety and depression were screened out for risk assessment. Results Among 295 COPD patients, 131 patients(44.4%)had anxiety/depression, including 111 patients(37.6%)with anxiety, 104 patients(35.2%)with depression, and 84 patients(28.5%)with both anxiety and depression. The mMRC score, CAT score and course of disease in COPD patients with anxiety and depression were higher than those in patients without anxiety and depression. The FEV1% PRED was lower than that of the non-anxiety and depression group, and the differences were statistically significant(all P<0.05). There was no significant difference between the two groups in gender composition, age, smoking, educational background, annual treatment cost, and acute exacerbation in the past year. mMRC score, CAT score, FEV1%PRED, duration of disease as independent variables, univariate logistic regression was performed, and the results showed that the above variables were all related to COPD complicated with anxiety and depression(P<0.05). CAT score(OR=1.074, P<0.05), FEV1%PRED(OR=0.981, P<0.05)was an independent risk factor for COPD complicated with anxiety and depression. Conclusion COPD patients with anxiety and depression have lower FEV1%PRED, higher mMRC and CAT scores. CAT score and FEV1%PRED are independent risk factors for COPD complicated with anxiety and depression. COPD patients with high CAT score and low FEV1% PRED are at higher risk. Screening of these patients can provide early warning, early detection, diagnosis and treatment for COPD patients with anxiety and depression, so as to improve the efficacy and prognosis of COPD patients.

参考文献/References:

1 Soriano JB, Lamprecht B. Chronic obstructive pulmonary disease: a worldwide problem[J]. Med Clin North Am, 2012, 96(4): 671-680.
2 任成山, 王关嵩, 钱桂生. 慢性阻塞性肺疾病的成因及其治疗的困惑与希望[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(2): 127-141.
3 Wang C, Xu J, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China( the China Pulmonary Health [CPH] study): a national cross-sectional study[J]. Lancet, 2018, 391(10131): 1706-1717.
4 Gómez FP, Rodriguez-Roisin R. Global Initiative for Chronic Obstructive Lung Disease(GOLD)guidelines for chronic obstructive pulmonary disease[J]. Curr Opin Pulm Med, 2011, 8(2): 81-86.
5 de Marco R, Pesce G, Marcon A, et al. The coexistence of asthma and chronic obstructive pulmonary disease(COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population[J]. PLoS One, 2013, 8(5): e62985.
6 Chung JW, Kong KA, Lee JH, et al. Characteristics and self-rated health of overlap syndrome[J]. Int J Chron Obstruct Pulmon Dis, 2014, 9:795-804.
7 Zareifopoulos N, Bellou A, Spiropoulou A, et al. Prevalence, contribution to disease burden and management of comorbid depression and anxiety in chronic obstructive pulmonary disease:a narrative review[J]. COPD, 2019, 16(5-6): 406-417.
8 Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970-2002[J]. JAMA, 2005, 294: 1255-1259.
9 Sciriha A, Lungaro-Mifsud S, Scerri J, et al. Health status of COPD patients undergoing pulmonary rehabilitation: A comparative responsiveness of the CAT and SGRQ[J]. Chron Respir Dis, 2017, 14(4): 352-359.
10 Zhong N, Wang C, Yao W, et al. Prevalence of chronic obstructive pulmonary disease in China: a large, population based survey[J]. Am J Respir Crit Care Med, 2007, 176: 753-760.
11 唐鲜娥, 潘江其, 周发伟, 等. Hcy、IL-1β与冠心病患者伴发抑郁的相关性研究[J]. 同济大学学报(医学版), 2017, 38(1): 90-93.
12 Yao HM, Xiao RS, Cao PL, et al. Risk factors for depression in patients with chronic obstructive pulmonary disease[J]. World J Psychiatr, 2020, 10(4): 59-70.
13 Yohannes AM, Kaplan A, Hanania NA. Anxiety and depression in chronic obstructive pulmonary disease: recognition and management[J]. Cleve Clin J Med, 2018, 85(2 Suppl 1): S11-S18.
14 Bock K, Bendstrup E, Hilberg O, et al. Screening tools for evaluation of depression in chronic obstructive pulmonary disease(COPD). A systematic review[J]. Eur Clin Respir J, 2017, 4(1): 1332931.
15 Hynninen KM, Breitve MH, Wiborg AB, et al. Psychological characteristics of patients with chronicobstructive pulmonary disease:a review[J]. J Psychosom Res, 2005, 59: 429-443.
16 陈华萍, 尹 燕, 贺斌峰, 等. 慢性阻塞性肺疾病合并焦虑抑郁的临床分析[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(6): 677-681.
17 Ng TP, Niti M, Tan WC, et al. Depressive symptoms and chronic obstructive pulmonary disease:effect on mortality, hospital readmission, symptom burden, functional status, and quality of life[J]. Arch Intern Med, 2007, 167(1): 60-67.
18 Montserrat-Capdevila J, Godoy P, Marsal JR, et al. Mental disorders in chronic obstructive pulmonary diseases[J]. Perspect Psychiatr Care, 2018, 54(3): 398-404.
19 董明林, 熊梦清, 胡卫华, 等. 慢性阻塞性肺疾病合并焦虑抑郁症的临床特征及相关危险因素分析[J]. 国际呼吸杂志, 2021, 41(4): 253-258.
20 Mehta JR, Ratnani IJ, Dave JI, et al. Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease[J]. East Asian Arch Psychiatry, 2014, 24(4): 148-155.
21 Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD Assessment Test[J]. Eur Respir J, 2009, 34: 648-654.
22 Lee YS, Park S, Oh YM, et al. Korean COPD Study Group. Chronic obstructive pulmonary disease assessment test can predict depression: a prospective multi-center study[J]. J Korean Med Sci, 2013, 28: 1048-1054.
23 Guillien A, Laurent L, Soumagne T, et al. Anxiety and depression among dairy farmers: the impact of COPD[J]. Int J Chron Obstruct Pulmon Dis, 2018, 13: 1-9.
24 von Siemens SM, Jörres RA, Behr J, et al. COSYCONET study group. Effect of COPD severity and comorbidities on the result of the PHQ-9 tool for the diagnosis of depression: results from the COSYCONET cohort study[J]. Respir Res, 2019, 20: 30.
25 Löwe B, Schenkel I, Carney-Doebbeling C, et al. Responsiveness of the PHQ-9 to psychopharmacological depression treatment[J]. Psychosomatics, 2006, 47: 62-67.
26 Matte DL, Pizzichini MM, Hoepers AT, et al. Prevalence of depression in COPD: A systematic review and meta-analysis of controlled studies[J]. Respir Med, 2016, 117: 154-161.
27 郭 晶, 牛津牧, 陈 哲. COPD 患者抑郁的发病情况[J]. 山东医药, 2015, 55(39): 69 -71, 72.
28 江 宁, 尹 燕, 侯 刚, 等. 哮喘-慢阻肺重叠患者焦虑、抑郁状态调查分析[J]. 中国医师杂志, 2021(7): 1007-1011.
29 Bordoni B, Marelli F, Morabito B, et al. Share Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath[J]. Monaldi Arch Chest Dis, 2017, 87(1): 811.
30 Zhovanyk NV, Tovt-Korshynska MI. Interaction between clinical and psychological changes among patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity[J]. Wiad Lek, 2019, 72(4): 635-638.
31 Panagioti M, Scott C, Blakemore A, et al. Overview of the prevalence,impact, and management of depression and anxiety in chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis, 2014, 9: 1289-1306.

备注/Memo

备注/Memo:
基金项目: 国家重点研发计划课题(2016YFC1304500)
通信作者: 魏征华,Email:weizh0610@126.com
龙 舟, Email: leiben56@163.com
更新日期/Last Update: 2022-10-20