支气管哮喘-慢性阻塞性肺疾病重叠合并抑郁的临床研究

目的 探讨支气管哮喘-慢性阻塞性肺疾病重叠（ACO）合并抑郁的危险因素。方法 选取我院呼吸内科2017年1月—2018年1月住院的稳定期ACO患者（ACO组,60例）、稳定期慢性阻塞性肺疾病患者（COPD组,59例）及非急性发作期支气管哮喘患者（哮喘组,22例）。对ACO组、COPD组及哮喘组患者进行汉密尔顿抑郁量表（HAMD）-17问卷调查,并检测患者第 1秒用力呼气容积占预计值百分比（FEV1%pred）和改良版英国医学研究会呼吸困难量表（mMRC）。按HAMD-17评分将ACO组分为非抑郁组（HAMD-17评分≤7分,15例）及抑郁组（HAMD-17评分＞7分,45例）,分析 ACO 患者合并抑郁可能存在的危险因素。结果 ACO 组 HAMD-17评分高于 COPD 组和哮喘组（P＜0.05）。ACO患者中抑郁者 mMRC≥2级及 FEV1%pred＜50%者所占比例均高于非抑郁者（均 P＜0.05）。Logistic回归分析结果显示,mMRC≥2级、FEV1%pred＜50%为 ACO患者发生抑郁的独立危险因素。结论 ACO合并抑郁的严重程度较COPD及支气管哮喘更重,临床应注意对ACO患者进行抑郁的筛查工作。

Clinical study of bronchial asthma-chronic obstructive pulmonary disease overlap with depression

Objective To investigate the risk factors for bronchial asthma-chronic obstructive pulmonary diseaseoverlap (ACO) complicated with depression. Methods A total of 141 stable ACO patients (included 60 cases in ACOgroup, 59 cases in stable COPD group and 22 cases in asthma group) hospitalized in our hospital from January 2017 toJanuary 2018 were included in this study. Hamilton depression scale (HAMD)-17 questionnaire survey was conducted inACO group, COPD group and asthma group. The percentage of forced expiratory volume in the first second (FEV1% pred)and the modified British medical research association dyspnea scale (mMRC) were measured in three groups of patients.According to HAMD-17 score, ACO group was divided into non-depression group (HAMD-17 score ≤ 7, n=15) anddepression group (HAMD-17 score > 7, n=45). The possible risk factors of depression were analyzed in ACO patients.Results The HAMD-17 scores were significantly higher in ACO group than those in the COPD group and asthma group(P＜0.05). The proportion of depressive patients with mMRC ≥ 2 and FEV1% pred＜50% was higher than that of nondepressive patients (all P＜0.05). Logistic regression analysis showed that mMRC≥2 and FEV1%pred＜50% wereindependent risk factors for depression in ACO patients. Conclusion The severity of depression is more serious in the ACOpatients than that in the COPD and the asthma patients. We should pay attention to screening depression in ACO patients.