慢性阻塞性肺疾病患者合并焦虑的相关因素分析_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

翟秋丽 , 徐康 ,  李秀

安徽医科大学第三附属医院呼吸与危重医学科（安徽合肥 230061）;

Corresponding author：

李秀, Email: 919296610@qq.com

Keywords：

慢性阻塞性肺疾病; 焦虑; 肺功能; 学历; C 反应蛋白

DOI：

10.7507/1671-6205.201904093

Video：

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目的探讨慢性阻塞性肺疾病（简称慢阻肺）患者合并焦虑的相关因素。方法分析安徽医科大学第三附属医院 2015 年 10 月至 2018 年 10 月住院治疗的慢阻肺患者 70 例。所有患者于出院前完成汉密尔顿焦虑量表（HAMA）调查及相关临床资料和社会人口学资料的采集，并于出院后 1 周门诊复诊时采集血标本，检测血清 C 反应蛋白（CRP）。根据 HAMA 评分将慢阻肺患者分为焦虑组和对照组，采用 Logistic 回归分析方法分析慢阻肺患者合并焦虑的相关因素。结果 70 例慢阻肺患者中 44 例合并焦虑。较高学历的慢阻肺患者更易产生焦虑情绪，初中及以上、小学、小学以下合并焦虑的占比分别为 86.7%、47.4%、42.9%（P=0.002）。合并焦虑的慢阻肺患者的第 1 秒用力呼气容积（FEV₁）较对照组更倾向于低水平［0.71（0.52，0.99）L 比 0.99（0.86，1.45）L，P=0.001］。焦虑组慢阻肺患者 CRP 水平较对照组高［13.1（0.47，18.18）mg/L 比 0.80（0.49，3.43）mg/L，P=0.000］。结论高血清 CRP 水平、高学历、低 FEV₁ 是慢阻肺患者合并焦虑的高危因素。

Citation： 翟秋丽, 徐康, 李秀. 慢性阻塞性肺疾病患者合并焦虑的相关因素分析. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(4): 393-397. doi: 10.7507/1671-6205.201904093 Copy

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16.	许银芳, 韩淑华, 林勇. 慢性阻塞性肺疾病患者合并焦虑/抑郁障碍的相关因素. 中国老年学杂志, 2012, 32(15): 3180-3182.
17.	姜垣, 李强, 肖琳, 等. 中国烟草流行与控制. 中国流行病学杂志, 2011, 32(12): 1181-1187.
18.	Deslee G, Burgel PR, Escamilla R, et al. Impact of current cough on health-related quality of life in patients with COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2091-2097.
19.	Cully JA, Graham DP, Stanley MA, et al. Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics, 2006, 47(4): 312-319.
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22.	Xu W, Collet JP, Shapiro S, et al. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. Am J Respir Critical Care Med, 2008, 178(9): 913-920.
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24.	García-Rivero JL, Esquinas C, Barrecheguren M, et al. Risk factors of poor outcomes after admission for a COPD exacerbation: multivariate logistic predictive models. COPD, 2017, 14(2): 164-169.
25.	Liukkonen T, Räsänen P, Jokelainen J, et al. The association between anxiety and C-reactive protein (CRP) levels: results from the Northern Finland 1966 birth cohort study. Eur Psychiatry, 2011, 26(6): 363-369.
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1. Singh D, Agusti A, Anzueto A, et al. Global Strategy For The Diagnosis, Management, And Prevention Of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J, 2019, 53(5): 1900164.
2. De Martinis M, Franceschi C, Monti D, et al. Inflammation markers predicting frailty and mortality in the elderly. Exp Mol Pathol, 2006, 80(3): 219-227.
3. Turan O, Yemez B, Itil O. The effects of anxiety and depression symptoms on treatment adherence in COPD patients. Prim Health Care Res Dev, 2014, 15(3): 244-251.
4. Abrams TE, Vaughan-Sarrazin M, Vander Weg MW. Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality. Psychosomatics, 2011, 52(5): 441-449.
5. Copeland WE, Shanahan L, Worthman C, et al. Generalized anxiety and C-reactive protein levels: a prospective, longitudinal analysis. Psychol Med, 2012, 42(12): 2641-2650.
6. 肖水源. 《社会支持评定量表》的理论基础与研究应用. 临床精神医学杂志, 1994, 4(2): 98-100.
7. 于中国. 如何计算体重指数?. 中老年保健, 2015, (1): 46.
8. 龙英全, 钟秋安, 潘姣姣, 等. 吸烟对男性人群体质指数与血压关系的影响. 中华疾病控制杂志, 2015, 19(3): 218-221.
9. 汤毓华, 张明园. 汉密顿焦虑量表(HAMA). 上海精神医学, 1984, (2): 64-66.
10. Laszlo G. Standardisation of lung function testing: helpful guidance from the ATS/ERS Task Force. Thorax, 2006, 61(9): 744-746.
11. 章迎春, 陈炜. 焦虑症的诊断和治疗. 全科医学临床与教育, 2009, 7(3): 211-212.
12. Eisner MD, Blanc PD, Yelin EH, et al. Influence of anxiety on health outcomes in COPD. Thorax, 2010, 65(3): 229-234.
13. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest, 2008, 134(4): 43S-56S.
14. Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage, 2006, 31(1): 58-69.
15. Hill K, Geist R, Goldstein R, et al. Anxiety and depression in end-stage COPD. Eur Respir J, 2008, 31(3): 667-677.
16. 许银芳, 韩淑华, 林勇. 慢性阻塞性肺疾病患者合并焦虑/抑郁障碍的相关因素. 中国老年学杂志, 2012, 32(15): 3180-3182.
17. 姜垣, 李强, 肖琳, 等. 中国烟草流行与控制. 中国流行病学杂志, 2011, 32(12): 1181-1187.
18. Deslee G, Burgel PR, Escamilla R, et al. Impact of current cough on health-related quality of life in patients with COPD. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2091-2097.
19. Cully JA, Graham DP, Stanley MA, et al. Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics, 2006, 47(4): 312-319.
20. DiNicola G, Julian L, Gregorich SE, et al. The role of social support in anxiety for persons with COPD. J Psychosom Res, 2013, 74(2): 110-115.
21. Hill K, Mangovski-Alzamora S, Blouin M, et al. Disease-specific education in the primary care setting increases the knowledge of people with chronic obstructive pulmonary disease: a randomized controlled trial. Patient Educ Couns, 2010, 81(1): 14-18.
22. Xu W, Collet JP, Shapiro S, et al. Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations. Am J Respir Critical Care Med, 2008, 178(9): 913-920.
23. 刘东兰. C 反应蛋白和与白介素-6 的检测在慢性阻塞性肺病治疗中的应用价值. 当代医学, 2016, 22(29): 39-40.
24. García-Rivero JL, Esquinas C, Barrecheguren M, et al. Risk factors of poor outcomes after admission for a COPD exacerbation: multivariate logistic predictive models. COPD, 2017, 14(2): 164-169.
25. Liukkonen T, Räsänen P, Jokelainen J, et al. The association between anxiety and C-reactive protein (CRP) levels: results from the Northern Finland 1966 birth cohort study. Eur Psychiatry, 2011, 26(6): 363-369.
26. Faravelli C, Sauro CL, Godini L, et al. Childhood stressful events, HPA axis and anxiety disorders. World J Psychiatry, 2012, 2(1): 13-25.

Chinese Journal of Respiratory and Critical Care Medicine

慢性阻塞性肺疾病患者合并焦虑的相关因素分析

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