慢性阻塞性肺疾病急性加重期合并抑郁症状的发生率及危险因素分析

Incidence of depressive symptoms and risk factors analysis in patients with acute exacerbation of chronic obstructive pulmonary disease

摘要:

目的 了解慢性阻塞性肺疾病急性加重期(AECOPD)患者抑郁症状发病情况及其影响因素,探讨AECOPD患者相关指标与抑郁症状的相关性。方法 选取2013年7月至2016年7月在扬州市第一人民医院呼吸内科住院的AECOPD患者共112例,并应用改良英国MRC呼吸困难指数(mMRC)、6 min步行距离(6MWD)、体质量指数(BMI)、第1秒用力呼气容积占预计值的百分比(FEV₁%pred)、用力肺活量(FVC)、CAT评分、BODE指数及医院焦虑抑郁量表(HADS)等指标对其进行调查。结果 112例AECOPD患者中48例合并抑郁症状,发生率为42.86%。AECOPD患者抑郁症状与FEV₁%pred、6MWD和付费报销比例呈负相关(分别为r=-0.69,-0.75,-0.38,P<0.01),与CAT评分、BODE指数和mMRC呈正相关(r=0.76,0.76,0.61,P<0.01)。AECOPD患者抑郁症状与性别、年龄、文化程度、吸烟、BMI、FEV_l/FVC则无相关性(P＞0.05)。结论 AECOPD患者容易合并抑郁症状,抑郁症状评分与FEV₁%pred、6MWD、付费方式、CAT评分、BODE指数以及mMRC有关。

Abstract:

Objective To investigate the occurrence of depressive symptoms and influencing factors in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and explore the association of depressive symptoms with related indicators of AECOPD. Methods A total of 112 AECOPD patients admitted in Department of Respiratory Diseases in our hospital from July 2013 to July 2016 were recruited in this study. Modified Medical Research Council dyspnea scale (mMRC), 6-minute walk distance (6MWD), body mass index (BMI), percentage of forced expiratory volume in one second in predicated value (FEV₁%pred), forced vital capacity (FVC), COPD assessment test (CAT), BODE index, and hospital anxiety and depression scale (HADS) were performed and measured for all the subjects. Results There were 48 patients out of the 112 cases (42.86%) having depressive symptoms. The depression scores were negatively correlated with FEV₁%pred, 6MWD, and charge-to-reimbursement ratio (r=-0.69,-0.75, -0.38, P<0.01), and positively correlated with CAT score, BODE index, and mMRC (r=0.76,0.76,0.61, P<0.01). However, the depression scores were not correlated with gender, age, educational level, smoking, BMI, or the ratio of FEV_l to FVC (FEV_l/FVC)(P>0.05). Conclusion AECOPD patients are prone to having depressive symptoms. And their depression scores are correlated with FEV₁%pred, 6MWD, ways of payment, CAT score, BODE index and mMRC.