慢性阻塞性肺疾病合并抑郁的发生率及危险因素分析

目的了解慢性阻塞性肺疾病(COPD)患者合并抑郁的发生率,探讨COPD患者合并抑郁的危险因素。方法选择2011年1月至2013年1月兰州大学第二医院门诊和住院治疗的215例COPD稳定期患者,采用病人健康问卷抑郁量表(PHQ-9)对患者抑郁状况进行评价,同时完成CAT量表、肺功能检查及相关病史(性别、年龄、身高、体重、吸烟史、教育程度)的采集。根据患者的临床症状(mMRC或CAT量表)、未来急性加重的风险、肺功能的异常程度(FEV1%pred)以及并发症的情况进行综合评估而分成A、B、C、D组。采用2检验及多因素Logistic回归分析COPD患者合并抑郁的发生率及危险因素。结果 COPD患者合并抑郁的发生率为37.7%,COPD的A、B、C、D各组间的抑郁发生率分别为18.5%、35.8%、46.5%和62.5%,组间差异有统计学意义(P<0.01)。COPD合并抑郁的发生与患者的性别、年龄、教育程度、FEV1%pred、CAT、BMI有关,与年龄、FEV1%pred、BMI呈负相关,与教育程度、CAT评分呈正相关。而吸烟和FEV1/FVC与COPD合并抑郁无显著相关性(P>0.05)。结论 COPD患者容易合并抑郁,A、B、C、D各亚组之间抑郁的发生率有明显差异。COPD合并抑郁与性别、年龄、教育程度、FEV1%pred、BMI和CAT评分有关。

Prevalence of Depression in Chronic Obstructive Pulmonary Disease and Risk Factors Analysis

Objective To investigate the prevalence of depression in patients with chronic obstructive pulmonary disease （COPD） and risk factors. Methods 215 patients with stable COPD were recruited in the study. The Patient Health Questionnaire-9 （PHQ-9） standardized scale were performed for the depression survey. Meanwhile CAT, pulmonary function test and the history taking （sex, age, height, weigh,smoking status,education level） were applied to evaluate all the COPD patients. The COPD patients were classified into A, B, C, and D groups according to 2011 GOLD new COPD classification system. Pearson chi-square test and multivariate logistic modeling were used to estimate the prevalence of depression and the risk factors. Results The prevalence of depression in COPD patients whose PHQ-9 scores ≥7 was 37. 7% with 18.5% ,35.8% ,46. 5%, and 62. 5% respectively in A, B, C, and D groups. There was significant difference in prevalence between each groups （ P 〈 0.05 ）. Compared with the COPD patients without depression, the COPD patients with depression had younger age, more female, higher education level, higher CAT scores and smaller means of body mass index （ BMI ）. Logistic analysis revealed that depression in COPD was associated with age, sex, education level, BMI,FEV1% pred and CAT scores. The patients who with younger age, female sex, higher education level, lower FEV1% pred, lower BMI and higher CAT scores were had higher rsik to be complicated with depression. However no significant difference was observed between different FEV1/FVC or smoking status. Conclusions This study confirms the high prevalence of depression in patients with stable COPD, and the prevalence in A, B, C, and D groups of COPD are different. Sex, age ,education level, FEV1% pred, BMI, and CAT scores are the risk factors of depression in COPD.