慢性阻塞性肺疾病生活质量及焦虑抑郁相关因素分析

目的 探讨慢性阻塞性肺疾病(COPD)患者生活质量及焦虑抑郁的相关影响因素,生活质量与焦虑抑郁的关系.方法 收集71例COPD患者的一般资料,肺功能,血气分析结果,并发放圣·乔治呼吸问卷(SGRQ),Zung焦虑、抑郁量表,进行生活质量、焦虑、抑郁情况评估.后由SPSS17.0软件进行统计分析.结果 ①71例患者中有抑郁症状者19例,占患者总数的26.76%,有焦虑症状者27例,占患者总数的38.03%,远高于普通人群的患病率.②SGRQ各分值、焦虑抑郁症状得分与性别年龄无相关性.除焦虑症状得分外,SGRQ各分值、抑郁症状得分均与病史呈正相关,病史与疾病影响部分相关性最强(r=0.354,P＜0.01).SGRQ各分值、焦虑抑郁症状得分均与吸烟呈正相关,吸烟与症状部分相关性最强(r=0.477,P＜0.01).身高、体质量指数(BMI)与活动部分、疾病影响、总分、焦虑症状得分呈负相关,与疾病影响、总分均具有明显相关性,分别为(r=-0.324,P＜0.01)和(r=-0.350,P＜0.01).③SGRQ各分值、焦虑抑郁症状得分均与肺功能,PO2呈负相关,焦虑抑郁症状得分与FEV1%pred呈明显负相关,分别为(r=-0.495,P＜0.01)和(r=-0.576,P＜0.01).④以生活质量总分为因变量,焦虑抑郁症状得分为自变量,通过多重线性回归分析示SGRQ总分与焦虑抑郁症状得分仍成线性相关,而分别以焦虑抑郁得分为因变量,SGRQ各分值为自变量,焦虑症状得分与SGRQ无明显相关性(t=-1.245～1.548,P＞0.05),抑郁症状得分与症状部分、疾病影响、总分相关性减弱(t=-0.193～2.444,P=0.017～0.050).结论 COPD患者生活质量、焦虑抑郁程度与病程、吸烟史、BMI、肺功能及氧分压密切相关,生活质量与焦虑抑郁症状得分具线性依存关系,生活质量下降可导致焦虑抑郁症状的产生,反之,焦虑抑郁可以导致生活质量下降,焦虑抑郁可能是影响COPD患者生活质量的独立危险因素.

Quality of life, anxiety and depression's influential factors in patients with chronic obstructive pulmonary disease,and the relationship among the quality of life, anxiety and depression

Objective To investigate the quality of life, anxiety and depression's influential factors in patients with chronic obstructive pulmonary disease, and investigate the relationship among the quality of life, anxiety and depression. Methods 71 COPD case were questioned with general information, lung function and arterial blood gas analysis results. Health status was assessed using the Saint George Respiratory Questionnaire and Zung anxiety /depression questionnaire. Then undertake multiple liner diagnosed as having depressive symptoms, and 27 (38.03%) were diagnosed as having the symptom of have no collection with gender and age. Except SAS score, each SGRQ score, sds score have positive correlation with case history. Compared with others, a strongest relationship was found between case history and impact (SGRQ)( r =0. 354, P ＜0.01). Each SGRQ score, sas/sds score have positive correlation with smoking. Compared with others, smoking was associate with a higher symptoms score( r=0. 477, P ＜0. 01). There was a negative correlation between BMI and activity (SGRQ), impact among each SGRQ score, symptom of anxiety, depression score and lung function, PO2. Symptom of anxiety, depression score have a strong negative correlation with FEV1%pred[( r =-0. 495, P ＜0.01)was independently related to anxiety and(or)depression. Conclusions The quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease had a close correlation with case story,smoking,BMI,lung function and PO2. Specially, the quality of life was independently related to anxiety and (or) depression.