【摘要】 目的分析COPD合并焦虑抑郁的患病率,探讨焦虑抑郁程度分级与COPD症状评分间的关系。方法选择154例COPD患者,通过问卷调查,评估患者医院焦虑抑郁量表(HADS)和COPD评估测试(CAT)评分,汉密尔顿抑郁量表(HAMD)评分,汉密尔顿焦虑量表(HAMA)评分,圣乔治呼吸问题调查问卷(SGRQ)总分,呼吸困难(m MRC)评分,结合肺功能检查,按照HADS≥11分表示存在焦虑、抑郁进行分组,进行相关因素分析;同时依据HAMD、HAMA进行焦虑抑郁分级,观察焦虑抑郁分级与COPD患者病情的关系。结果 154例COPD患者中,41例合并焦虑抑郁障碍,患病率为26.63%,其中单纯焦虑或抑郁患者6例,轻度焦虑抑郁患者19例,中重度焦虑抑郁患者16例,COPD合并焦虑抑郁组在性别、年龄、病程、吸烟、教育水平方面与单纯COPD无差异(P>0.05),但低收入人群比例、疾病每年花费、肺功能分级3、4级患者比例显著高于单纯COPD组(P<0.05);在与COPD症状评分关系的研究中,结果表明HAD评分与HAMD评分,HAMA评分,SGRQ总分,m MRC评分呈正相关,与肺功能FEV占预计值%、FEV1/FVC呈负相关(P<0.05);焦虑抑郁分级分析结果显示合并中重度焦虑抑郁COPD患者HAMD评分、HAMA评分、SGRQ总分、m MRC评分、FEV占预计值%、FEV1/FVC均较合并轻度焦虑抑郁COPD患者差(P<0.05)。结论 COPD合并焦虑抑郁的患病率较高,且焦虑抑郁分级程度与患者病情严重度与呈正相关,提示临床上在治疗COPD患者基础疾病的同时还需关注患者的精神疾病,以进一步提高疗效。更多还原

【Abstract】 Objective To analyze the prevalence of chronic obstructive pulmonary disease( COPD combined with anxiety/depression,and to explore the relationship between the anxiety/depression grade and COPD symptom score. Methods A total of 154 COPD patients were enrolled in this study. Hospital Anxiety and Depression Scale( HADS) and COPD assessment test( CAT),Hamilton Depression Scale( HAMD),Hamilton Anxiety Scale( HAMA),St. George’ s Respiratory Questionnaire( SGRQ) and dyspnea( m MRC)were used for the patients. According to the pulmonary function test,the patients were grouped according to HADS( >11) indicating anxiety/depression,and the literature factors were analyzed. Meanwhile,the anxiety/depression was graded according to the scores of HAMD and HAMA,and the relationship between anxiety and depression grading and the condition of COPD patients was observed. Results Among the 154 COPD patients,41 were combined with anxiety/depression,with the prevalence rate of 26. 63%. Among 41 patients,6 had simple anxiety/depression,19 had mild anxiety/depression,and 16 had moderate or severe anxiety/depression.There was no significant difference in sex,age,course of disease,smoking history or educational level between the patients with COPD combined with anxiety/depression and the patients with simple COPD( P > 0. 05).However,there were significant differences in the proportions of rural patients,low-income population,the patients with higher annual cost of disease,and the patients with pulmonary functions grading 3 and 4 between the patients with COPD combined with anxiety/depression and the patients with simple COPD( P < 0.05). In the study of the relationship between HAD score and COPD symptom score,the results showed that HAD score was positively correlated with HAMD score,HAMA score,SGRQ total score and m MRC score,and negatively correlated with the FEV and FEV1/FVC of the pulmonary function. The results of anxiety/depression grading analysis showed that the HAMD score,HAMA score,SGRQ total score,m MRC score,FEV ratio and FEV1/FVC of the COPD patients with moderate and severe anxiety/depression were worse than those of the COPD patients with mild anxiety/depression( P < 0. 05). Conclusion The prevalence is high in the patients with COPD combined with anxiety/depression and the degree of anxiety/depression is positively correlated with the severity of COPD,suggesting that doctors should pay more attention to the mental illness of the patients in the treatment of COPD patients,in order to further improve the curative effects.更多还原