支气管哮喘控制水平与焦虑抑郁情绪关系的研究

目的探讨支气管哮喘(简称哮喘)的控制水平与焦虑抑郁情绪的关系,分析哮喘患者焦虑抑郁发生的可能原因。方法入选2012年5月—2013年5月解放军总医院呼吸科门诊62例哮喘患者进行横断面研究,评估其哮喘控制水平、肺功能及焦虑抑郁情绪。采用2008年支气管哮喘防治指南的控制标准评估哮喘控制水平。采用综合医院焦虑抑郁量表(HAD)评测焦虑和抑郁情绪。将62例患者分为完全控制组、部分控制组及未控制组,分析不同哮喘控制水平与患者焦虑抑郁情绪的关系。结果 62例哮喘患者中存在焦虑18例(29.0%),抑郁20例(32·3%),同时存在焦虑和抑郁10例(16.1%)。病程和年龄与抑郁分数之间存在显著正相关(r=0·300,P<0·05;r=0·307,P<0.05),而与焦虑分数之间无显著相关(r=0.222,P>0.05;r=-0.023,P>0.05)。未控制组患者焦虑和抑郁分数和发生率均朗显高于完全控制组及部分控制组(P<0.01,P<0.05)。哮喘控制良好与焦虑和抑郁情绪发生率呈负相关(r值分别为-0.334和-0.416,P<0.01)。ACT评分与焦虑和抑郁分数之间存在显著负相关(r=-0.341,P<0.01;r=-0.464,P<0.01)。ACQ评分与焦虑和抑郁分数之间存在显著正相关(r=0.378,P<0.01:r=0.443,P<0.01)。FEV_1%与焦虑抑郁分数之间无显著相关(r=-0.096,P>0.05;r=-0.126,P>0.05)。PEF%与焦虑抑郁分数之间无显著相关(r=-0.240,P>0.05;r=-0.240,P>0.05)。焦虑组与非焦虑组相比,FEV_1%、PEF%较低,但差异无统计学意义(P>0.05)。抑郁组与非抑郁组相比,FEV_1%、PEF%较低,但差异无统计学意义(P>0.05)。气道炎性指标(FeNO)与焦虑抑郁分数之间无显著相关(r=0.014,P>0.05;r=-0.073,P>0.05)。结论近1/3的哮喘患者伴有焦虑抑郁情绪。哮喘控制水平与患者焦虑抑郁情绪密切相关,哮喘控制不佳可增加患者焦虑和抑郁的发生率。哮喘症状未控制、生活质量下降可能是哮喘患者发生焦虑抑郁情绪的重要原因。焦虑抑郁情况与患者肺功能和气道炎性指标之间无显著相关性。

Study of the relation between bronchial asthma control level and anxiety and depression

Objective To analysis bronchial asthma （asthma） control level and its relationship with anxiety or de -pression, to explore the possible reason of anxiety and depression of asthma patients .Methods Selected from May 2012 to May 2013, 62 cases of clinic patients in PLA General Hospital , conducted a cross-sectional study of pulmonary with asthma , to assess their level of asthma control , lung function and anxiety and depression .By using 2008 Standard Guide Bronchial Asthma control criterion to assess asthma control level .Integrated hospital anxiety and depression scale （HAD） to evaluate of anxiety and depression.62 patients were divided into an entirely control group , partially control group and the non-control group to analyze the relationship between different levels of asthma control in patients with anxiety and depression .Results Anxiety in 18 cases （29.0%）, depression in 20 patients （32.3%） in the presence of 62 cases of patients with asthma, and the presence of anxiety and depression in 10 patients （16.1%）.Between duration and age and depression scores were signifi -cantly positively correlated （ r =0.300, P ＆lt;0.05; r =0.307, P ＆lt;0.05）, while between anxiety scores and no significant correlation （ r =0.222, P ＆gt;0.05; r =-0.023, P ＆gt;0.05）.No control group of patients and incidence of anxiety and de -pression scores were significantly higher than the control group and some completely control group （ P ＆lt;0.01, P ＆lt;0.05）. Asthma is well controlled and the incidence of anxiety and depression were negatively correlated （r values were -0.334 and-0.416, P ＆lt;0.01）.Between ACT scores and anxiety and depression scores were significantly negatively correlated （ r =-0.341, P ＆lt;0.01; r =-0.464, P ＆lt;0.01）.ACQ score between anxiety and depression scores were significantly positively correlated （ r =0.378, P ＆lt;0.01; r =0.443, P ＆lt;0.01）.FEV no significant correlation between 1% and anxiety and de-pression scores （ r =-0.096, P ＆gt;0.05; r =-0.126, P ＆gt;0.05）.There was no significant correlation between PEF %with anxiety and depression scores （ r =-0.240, P ＆gt;0.05; r =-0.240, P ＆gt;0.05）.Anxiety group compared with the non-anxious group, FEV1%, PEF% lower, but the difference was not statistically significant （ P ＆gt;0.05）.Depression group compared with non-depressed group, FEV1%, PEF% lower, but the difference was not statistically significant （ P ＆gt;0.05）. There was no significant correlation between airway inflammatory markers （FeNO） and anxiety and depression scores （ r =0.014, P ＆gt;0.05; r =-0.073, P ＆gt;0.05）.Conclusion Nearly a third of the asthmatic patients suffer from anxiety and de -pression.Level of asthma control in patients with anxiety and depression are closely related to poorly controlled asthma may in -crease the incidence of anxiety and depression .Uncontrolled asthma symptoms, quality of life may be an important cause of asthma patients with anxiety and depression .There was no significant correlation between anxiety and depression in patients with lung function and airway conditions and inflammatory markers .