哮喘-慢阻肺重叠患者焦虑、抑郁状态调查分析

Investigation and analysis of anxiety/depression in patients with asthma-COPD overlap

目的了解哮喘-慢阻肺重叠(ACO)患者合并焦虑和(或)抑郁的发生情况,探讨其相关因素。方法选取2018年3月至2019年3月在中国医科大学附属第一医院呼吸内科门诊就诊或随访的稳定期ACO患者53例、哮喘患者74例和慢阻肺患者138例,采用汉密尔顿抑郁量表(HAMD)及汉密尔顿焦虑量表(HAMA)对三组患者进行焦虑、抑郁状态评估,并分析ACO患者发生焦虑和(或)抑郁的危险因素。结果ACO、哮喘及慢阻肺组合并焦虑的患者数分别为33例(62.3%)、35例(47.3%)和69例(50.0%),合并抑郁的患者数分别为29例(54.7%)、25例(33.8%)和58例(42.0%),ACO组合并抑郁的患者比例明显高于哮喘组(P<0.05)。ACO、哮喘及慢阻肺组同时合并焦虑和抑郁的患者数分别为28例(52.8%)、24例(32.4%)和52例(37.7%),ACO组明显高于哮喘组(P<0.05)。多因素logistic回归分析结果显示慢性阻塞性肺疾病评估测试(CAT)评分>10分是ACO患者发生焦虑(OR=15.000;P<0.01)和(或)抑郁(OR=8.667;P<0.01)的独立危险因素。结论焦虑、抑郁常见于慢性气道疾病患者,与哮喘患者对比,ACO患者更易合并焦虑和(或)抑郁,对CAT评分高的ACO患者应重视焦虑/抑郁的筛查。

Objective We aimed to estimate the incidence of anxiety or depression in asthma-chronic obstructive pulmonary disease(COPD)overlap(ACO)patients and explore its related factors.Methods Stable patients who were treated or followed up in the outpatient department of respiratory medicine in the First Hospital of China Medical University from March 2018 to March 2019 were enrolled,including 53 ACO patients,74 asthma patients,and 138 patients with COPD.Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)were used to evaluating the anxiety and depression status of the three groups of patients,and the risk factors of anxiety and/or depression in ACO patients were analyzed.Results There were 33 cases(62.3%),35 cases(47.3%)and 69 cases(50.0%)combined with anxiety in ACO,asthma and COPD group;there were 29 cases(54.7%),25 cases(33.8%)and 58 cases(42.0%)combined with depression in ACO,asthma and COPD group,respectively.The patients with depression in ACO were significantly higher than those in asthma group(P<0.05).There were 28 patients(52.8%),24 patients(32.4%)and 52 patients(37.7%)combined with anxiety and depression in ACO,asthma and COPD group,respectively,with significant difference in ACO group and asthma group(P<0.05).Multivariate logistic regression analysis showed that chronic obstructive pulmonary disease assessment test(CAT)scor^10 was associated with anxiety(OR=15.00,P<0.01)or depression(OR=8.667,P<0.01)in patients with ACO.Conclusions Anxiety/depression is common in chronic airway disease.Compared with asthma,anxiety and/or depression is more frequent in the patients with ACO.ACO patients with high CAT scores should pay attention to screening for anxiety/depression.