焦虑、抑郁对慢性阻塞性肺疾病评分的影响

Influence of symptoms of anxiety and depression on COPD assessment test scores

目的探讨焦虑、抑郁对COPD患者肺功能及CAT评分的影响,并研究最新的慢性阻塞性肺疾病全球倡议(GOLD)不同分级中焦虑、抑郁的分布情况。方法 152例COPD患者门诊、入院接受肺功能检查,并对其进行慢性阻塞性肺疾病评分(the COPD Assessment Test CAT)、改良英国MRC呼吸困难指数评分、医院焦虑和抑郁量表(HADS)评估,了解COPD患者焦虑和/或抑郁的发病率;分析不同水平焦虑、抑郁对COPD患者肺功能、CAT得分的影响。结果 152例患者中,焦虑和/或抑郁的患病率为36.8%(56例),女性患病人数较男性多,同时随着年龄的增加,其患病率也增高;无焦虑、抑郁组肺功能各项指标都明显优于有焦虑和/或抑郁组(P<0.05);无焦虑、抑郁组CAT得分明显低于有焦虑和/或抑郁组(P<0.05),相同肺功能水平组间,症状重组焦虑和/或抑郁的患病率明显高于症状轻组(P<0.05)。结论 COPD患者常伴有焦虑、抑郁情绪;焦虑、抑郁情绪严重影响COPD患者的肺功能、生活质量;按2011年GOLD指南提出的COPD不同分级中,焦虑和/或抑郁的患病情况是不同的,即其症状越重,焦虑和/或抑郁的患病率越高,而与气流受限程度无关。

Objective To explore the anxiety, depression, effects on the pulmonary function, CAT scores and the relationship between the updated GOLD classification and symptoms of anxiety and depression. Methods Lung function was examined in 152 patients with COPD of outpatient service and hospitalization, and CAT, mMRC and HADS were evaluated in the COPD patients with anxiety or depression of different degrees. Then their blood gas indexes were compared. Results 152 cases of patients, the prevalence of anxiety and/or depression was 36.8% （56 cases） , more women than men are number of cases, at the same time as the increase of the age, its prevalence is higher; Lung function of the group without anxiety and/or depression were significantly superior to the group with anxiety and/or depression （ P 〈 0.05 ） ; Without anxiety and/or depression group, CAT score was obviously lower than the group with anxiety and/or depression （ P 〈 0.05 ） ; between the same level of lung function groups, the prevalence of anxiety and/or depressive in the symptoms of severe group was higher than the symptom of light group （ P 〈 0.05 ）. Conclusions COPD patients are always complicated with anxiety or depression, Anxiety and depression seriously affect the pulmonary function and the quality of life in COPD patients, the prevalence of symptoms of anxiety and depression is differently distributed across the updated GOLD groups. It depends on symptoms; the heavier the symptoms, the higher the prevalence of anxiety and depression.