慢性阻塞性肺疾病急性加重患者焦虑抑郁状况与炎症因子变化的研究

目的探讨慢性阻塞性肺疾病急性加重（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）患者焦虑或抑郁状态的发生状况,及其多种炎症因子变化。方法对因AECOPD住院的患者进行医院焦虑抑郁量表问卷调查、慢性阻塞性肺疾病评估测试,以及血清多种炎症因子的检测。结果所有完成研究的64例患者中,有26例患者出现不同程度的焦虑状态和/或抑郁状态。不同分级MMRC患者及不同程度影响CAT评分的患者间的焦虑状态和抑郁状态发生率差异有统计学意义。与非焦虑状态患者相比,焦虑状态患者间血清IL-6及IL-10水平增高;同时抑郁状态患者的血清IL-6、IL-10及IL-17水平也高于非抑郁状态患者。但是否焦虑或抑郁状态患者间TNF-α及IL-4水平间差异并无统计学意义。结论 AECOPD患者有较高的焦虑、抑郁状态发生率,COPD合并焦虑、抑郁状态患者部分炎症因子水平发生变化,但这种变化的意义尚未明确。

Research of anxiety,depression state and change of inflammatory factors in AECOPD patients

Objective To observe anxiety and depression states in patients hospitalized with AECOPD,and to study the effect of CAT,MMRC on the anxiety and depression in these peoples.Methods The hospital anxiety and depression scale（HAD）questionnaire,MMRC dyspnea scale,CAT（COPD assessment test） were completed by the patients with an acute exacerbation of COPD.And the serum level of several inflammatory factors were detected such as interleukin-6（IL-6）,IL-10 and so on.Results Among the 64 patients,26 patients were in accordance with anxiety states and（or）depression states.Significant differences of the incidence of anxiety states or depression states were observed among the patients with different grading MMRC score and different grading CAT score.A significant increase in IL-6 and IL-10 levels was observed in the anxiety states patients compared to non-anxiety states patients.While the same changing of IL-6,IL-10,IL-17levels also occurred to the patients with or not with depression states,but the levels of TNF-αand IL-4 were no statistical difference between two groups.Conclusions There is a high incidence of anxiety state and/or depression state in AECOPD patients which are unrecognized and untreated in most of the cases.The COPD patients should have a preventive and therapeutic role in this comorbidity and improve the daily care and quality of life.