慢性阻塞性肺疾病患者合并焦虑抑郁的危险因素分析

Analysis of Risk Factors for Combined Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者合并焦虑抑郁的危险因素。方法回顾性分析2020年1—12月包头医学院第二附属医院收治的120例COPD患者资料,由经过专门培训的调查人员对所有患者进行不良情绪评估,根据量表评估情况,将患者分为负面情绪组(50例)与对照组(70例),对比两组基线资料,分析导致负面情绪发生的危险因素。结果120例COPD患者中,HAMA评分为(14.79±5.02)分,HAMD评分为(9.81±4.86)分,共50例患者存在不良情绪,占比为41.67%。单因素分析中,负面情绪组男性、年龄≥60岁、病程≥8年、自费、入院前6个月急性加重次数≥2次、独居、肺功能FEV1%值<75%、6,min步行试验结果<400 m、CAT评分≥30分占比高于对照组,差异有统计学意义(χ^(2)=15.886、13.714、15.765、9.143、14.875、13.473、27.554、18.317、20.954,P<0.001);两组学历、基础疾病、婚姻情况相比,差异无统计学意义(P>0.05)。Logistic回归分析:男性(OR=5.013,P<0.001)、年龄≥60岁(OR=4.200,P<0.001)、病程≥8年(OR=5.559,P<0.001)、自费(OR=3.182,P=0.003)、入院前6个月急性加重次数≥2次(OR=5.612,P<0.001)、独居(OR=5.516,P=0.001)、肺功能FEV1%值<75%(OR=8.727,P<0.001)、6 min步行试验<400 m(OR=5.524,P<0.001)、CAT评分≥30分(OR=6.382,P<0.001)是COPD患者发生焦虑抑郁情绪的独立危险因素。结论COPD患者极易出现焦虑抑郁情绪,男性、年龄≥60岁、病程≥8年、自费、入院前6个月急性加重次数≥2次、独居、肺功能FEV1%值<75%、6 min步行试验结果<400 m、CAT评分≥30分是其独立影响因素,临床需予以高度重视,以降低不良情绪对疾病、治疗效果的影响,从而改善患者预后。

Objective To investigate the risk factors for combined anxiety and depression in patients with chronic obstructive pulmonary disease(COPD).Methods The data of 120 COPD patients admitted to the Second Affiliated Hospital of Baotou Medical College from January to December 2020 were retrospectively analyzed,and all patients were assessed for adverse mood by specially trained investigators.According to the scale assessment,patients were divided into negative mood group(50 cases)and control group(70 cases).Baseline data were compared between the two groups,and risk factors contributing to the occurrence of negative mood were analyzed.Results In 120 patients with COPD,the HAMA score was(14.79±5.02)points and the HAMD score was(9.81±4.86)points,and a total of 50 patients had negative emotions,accounting for 41.67%.In the univariate analysis,the negative mood group had a higher percentage of men,age≥60 years,disease duration≥8 years,self-pay,number of acute exacerbations≥2 times in the 6 months before admission,living alone,pulmonary function FEV1% value<75%,six-minute walk test result<400 m,and CAT score≥30 points than the control group,and the difference was statistically significant(χ^(2)=15.886,13.714,15.765,9.143,14.875,13.473,27.554,18.317,20.954,P<0.001).There was no statistically significant difference between the two groups compared to education,underlying disease,and marital status(P>0.05).Logistic regression analysis:male(OR=5.013,P<0.001),age≥60 years(OR=4.200,P<0.001),disease duration≥8 years(OR=5.559,P<0.001),self-pay(OR=3.182,P=0.003),number of acute exacerbations≥2 in the 6 months before admission(OR=5.612,P<0.001),patient living alone(OR=5.516,P=0.001),pulmonary function FEV1% value<75%(OR=8.727,P<0.001),six-minute walk test<400 m(OR=5.524,P<0.001),and CAT score≥30 points(OR=6.382,P<0.001)were the independent risk factors for the development of anxiety and depression in COPD patients.Conclusion Patients with COPD are highly susceptible to anxiety and depression,and men,age≥60 years,disease duration≥8 years,selfpayment,number of acute exacerbations≥2 in the 6 months before admission,living alone,pulmonary function FEV1% value<75%,six-minute walk test result<400 m,and CAT score≥30 points are their independent influencing factors.Clinical attention needs to be paid to reduce the impact of adverse emotions on disease and treatment outcome in order to improve patient prognosis.