合并抑郁症状的COPD患者与其BODE指数及生活质量的相关性分析

Relationship between depression in patients with COPD and BODE index and health-related quality of life

目的 通过应用流行病学研究中心抑郁自评量表（center for epidemiologic studies depression，CES-D）量表调查COPD患者合并抑郁症状的情况，探讨合并抑郁症状的COPD患者与其BODE（body mass index，degree of air-flowobstruction，dyspnea，exercise capacity）指数及生活质量的相关性。方法74例稳定期COPD患者分别完成CES—D评估、肺功能检测、BMI检测、改良版MRC呼吸困难指数评估、6分钟步行试验和圣乔治呼吸问卷调查等。结果COPD患者中合并抑郁症状的占48．6％（n=36）。CES-D评分与FEV，％pred呈低度负相关（r=-0．21，P=0．01）。COPD患者中抑郁症状的患病率与BODE指数分级呈正相关（r=0．61，P=0．02）。圣乔治呼吸问卷评分与COPD患者的抑郁症状有相关性（r=0．58，P=0．004）。结论COPD患者中抑郁症状的患病率及抑郁程度与BODE指数、呼吸功能受损程度等均相关。COPD患者的抑郁程度与圣乔治呼吸问卷评分相关。BODE指数对减少COPD患者合并抑郁症状的患病率和改善其生活质量有指导作用。

Objective To investigated the prevalence of depression among patients with COPD using the center for epidemiologic studies depression （CES-D） scale, meanwhile the relationship between the BODE （body mass index, degree of air-flow obstruction, dyspnea, exercise capacity） index, health- related quality of life （St George＇ s Respiratory Questionnaire [SGRQ]）, and depression were explored. Methods We recruited 74 stable patients with COPD. Subjects completed the CES-D, and measurements were made of pulmonary function, body mass index（BMI）, modified medical research council（mMRC） dyspnea scale, 6-rain walk test （6MWT）, and SGRQ. Results Depression was evident in 48.6 %（ n = 36） of the subjects. A weak negative correlation was found between the CES-D scores and the percent of predicted FEV1 （FEV1 %pred）（ r =-0.21, P = 0.01 ）. The prevalence of depression in COPD patients showed a positive association with BODE stage（ r =0.61, P =0.02）. Scores for the total SGRQ were significantly correlated with stable COPD patients who were depressed. Conclusions We found the prevalence of depression increased with BODE stage. Depression among stable COPD patients was associated with impairment in respiratory function and SGRQ scores. The BODE index can guide how to decrease the prevalence of depression in COPD patients and improve their health-related quality of life.