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

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目的:分析住院慢性阻塞性肺疾病(COPD)患者合并焦虑抑郁症的临床特征及相关危险因素。方法:选取2019年1月至10月武汉大学人民医院呼吸与危重症医学二科153例COPD患者作为研究对象进行横断面研究,根据医院焦虑抑郁量表评分和肺功能结果分为单纯COPD组和COPD合并焦虑抑郁症组,比较2组临床特征,采用单因素和多因素逻辑回归分析COPD合并焦虑抑郁症的相关危险因素。结果:(1)61例(39.9%)COPD患者合并焦虑抑郁症,其中合并焦虑症38例(28.4%),合并抑郁症55例(35.9%);同时存在焦虑抑郁症者32例(20.9%);(2)COPD合并焦虑抑郁症组过去1年有COPD急性加重、合并重度COPD比例、改良版英国医学研究委员会呼吸困难量表(mMRC)评分、慢性阻塞性肺疾病评估测试(CAT)评分、动脉血二氧化碳分压(PaCOn 2)更高,病程更长,用力肺活量占预计值百分比(FVC%pred)、第1秒用力呼气容积、第1秒用力呼气容积占预计值百分比更低(n P值均<0.05);(3)以COPD合并焦虑抑郁症为因变量,体质量指数(BMI)、病程、过去1年急性加重、第1秒用力呼气容积占预计值百分比、重度COPD、PaCOn 2、mMRC评分、CAT评分为自变量,分别行单因素逻辑回归,结果示上述变量均与COPD合并焦虑抑郁症有关(n P值均<0.05);(4)将病程、过去1年有COPD急性加重、重度COPD、PaCOn 2分别校正年龄、BMI行二元逻辑回归分析,结果示病程、过去1年有COPD急性加重、重度COPD、PaCOn 2为COPD合并焦虑抑郁症的危险因素(n P值均<0.05);将病程、过去1年有COPD急性加重、重度COPD、PaCOn 2与年龄及BMI同时纳入二元逻辑回归方程,结果示过去1年有COPD急性加重为COPD合并焦虑抑郁症的独立危险因素。n 结论:COPD患者合并焦虑抑郁症的比例较高,COPD合并焦虑抑郁症患者过去1年COPD急性加重更频繁,重度COPD的比例更高,病程更长,mMRC评分和CAT评分更高。过去1年COPD急性加重是COPD合并焦虑抑郁症的独立危险因素。“,”Objective:To analyze the clinical characteristics and related risk factors of inpatients with chronic obstructive pulmonary disease (COPD) with anxiety and depression.Methods:From January 2019 to October 2019, a total of 153 patients with COPD in the Second Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, were selected as the object of cross-sectional study, and according to the score of hospital anxiety and depression scale and the results of pulmonary function, they were divided into the group with simple COPD and the group with COPD combined with anxiety and depression.The clinical characteristics of the two groups were compared.The risk factors related to COPD with anxiety and depression were analyzed using single factor and multifactor logistic regression.Results:(1)Sixty-one cases (39.9%) of COPD combined with anxiety and depression group.Thirty-eight cases (28.4%) with combined anxiety, fifty-five cases (35.9%) with combined depression.Thirty-two cases (20.9%) with anxiety and depression.(2)In the COPD group with anxiety and depression group, there was a higher proportion of acute exacerbation of COPD in the past year, a higher proportion of combined severe COPD, a higher modified Medical Research Council (mMRC) score, a higher COPD assessment test (CAT) score, and a longer course of disease, while forced vital capacity percent predicted, forced expiratory volume in the first second (FEVn 1) and FEVn 1 in percent predicted values (FEVn 1%pred) were lower, and the differences were statistically significant ( all n P<0.05). (3)Taking COPD combined with anxiety and depression as the dependent variables, body mass index (BMI), course of disease, acute exacerbation of COPD in the past year, FEVn 1%pred, severe COPD, arterial partial pressure of carbon dioxide (PaCOn 2), mMRC score, CAT score as independent variables, respectively single factor logistic regression was performed, and the results showed that all the above variables were related to COPD complicated with anxiety and depression(all n P<0.05). (4)Binary logistic regression analysis of the disease course, acute exacerbation of COPD in the past year, severe COPD, PaCOn 2, age and BMI, respectively, the results showed that they were all independent risk factors for COPD complicated with anxiety and depression (n P<0.05). The course of disease, acute exacerbation of COPD in the past year, severe COPD, PaCOn 2, age, and BMI were simultaneously included in the binary logistic regression equation.The results showed that acute exacerbation of COPD in the past year was due to COPD complicated with anxiety and depression independent risk factors.n Conclusions:The prevalence of COPD patients with anxiety and depression is relatively high.Acute exacerbation of COPD have been more frequent in the past year, the proportion of patients with severe COPD is higher, the disease course is longer, the mMRC score and CAT score are higher.Acute exacerbation of COPD in the past year is an independent risk factor for COPD complicated with anxiety and depression.
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