焦虑、抑郁与慢性阻塞性肺疾病的相关性分析

The association analysis of anxiety and depression with pulmonary symptoms in chronic obstructive pulmonary disease

目的探讨焦虑、抑郁与慢性阻塞性肺疾病(COPD)症状的相关性,并分析COPD严重程度及患者活动能力对其相关性的影响。方法纳入2013年1-12月于重庆市綦江区人民医院确诊为COPD的患者,所有患者均完成相关心理测试,包括:简明疲劳量表、UCSD气促问卷、状态-特质焦虑问卷、贝克抑郁自评问卷,并评估患者疾病严重程度及活动能力(6 min步行试验,6MWT)。结果共164例COPD患者纳入研究,多因素Logistic回归分析结果显示,焦虑、抑郁均与COPD患者疲劳、气促、COPD发作频率显著相关;通过分层回归分析,校正性别、年龄、BMI等混杂因素后,6MWT可显著影响焦虑与气促(P=0.008;ΔR2=0.03)、COPD发作频率(P=0.021;ΔR2=0.02)的相关性,但对焦虑与疲劳的相关性无显著影响(P=0.135);6MWT对抑郁与COPD症状间的相关性无显著影响(P>0.05)。COPD严重程度对焦虑或抑郁与COPD症状间的相关性无显著影响(P>0.05)。结论焦虑及抑郁与疲劳、气促及COPD发作频率密切相关,改善COPD患者症状可明显提高其生活质量。

Objective To investigate the association of anxiety and depression and symptoms in chronic obstructive pulmonary disease（ COPD）, and analyze the impact of severity and the functional capacity on the association. Methods Patients with COPD from 2013-01 to 2013-12 in our hospital were enrolled in the study.Patients completed a psychosocial test including ： Brief Fatigue Inventory, UCSD Shortness of Breath Questionnaire, State-Trait Anxiety Inventory,and Beck Depression Inventory,and disease severity and functional capacity（six-minute walk test,6MWT） were also obtained.Results Overall 164 COPD patients were enrolled in the study. Through multivariate Logistic regression analysis, it showed that anxiety and depression were significantly associated with fatigue, shortness of breath and frequency of COPD symptoms; through hierarchical regression analysis, after adjustment for sex, age, BMI and other confounding factors,6MWT could significantly affect the correlation between anxiety and shortness of breath（P =0.008; ΔR2 =0.03） and the correlation between anxiety and frequency of COPD symptoms（P=0.021; ΔR2=0.02）, but it could not significantly affect the correlation between anxiety and fatigue（P =0.135）. In addition, 6MWT could not significantly affect the correlation between depression and COPD symptoms（P 〉0.05）. The correlation between anxiety or depression and COPD symptoms could not be significantly affected by FEV1（P 〉0.05）. Conclusions Anxiety and depression were closely related to fatigue, shortness of breath and frequency of COPD symptoms.Improving symptoms of COPD patients may significantly improve quality of life.