述情障碍在慢性阻塞性肺疾病中的流行及影响因素分析

目的 分析慢性阻塞性肺疾病(慢阻肺)合并述情障碍的流行特征及相关影响因素。方法 对842例慢阻肺患者进行调查采用多伦多述情障碍量表评价述情障碍,并测量肺功能,采用logistic回归分析慢阻肺合并述情障碍的影响因素。 结果 慢阻肺患者中合并述情障碍组与慢阻肺组相比,男性、BMI、吸烟、FEV1%预测值、抑郁和焦虑评分、mMRC评级和SGRQ评分均有统计学意义(P<0.05)。Logistic分析结果显示,FEV1%预测值、焦虑和抑郁、mMRC、SGRQ为慢阻肺合并述情障碍的独立危险因素OR值及95%CI分别为1.296(1.256～1.337)、1.238(1.097～1.396)和1.178(1.034～1.340)、1.297(1.274～1.320)、1.627(1.401～1.890)],年龄和BMI为其保护因素OR值及95%CI分别为0.886(0.794～0.998)和0.879(0.781～0.989)]。结论 FEV₁%预测值、抑郁和焦虑、mMRC、SGRQ评分为慢阻肺合并述情障碍的独立危险因素。

Prevalence and influencing factors in COPD patients with alexithymia

Objective To analyze the epidemic characteristics and risk factors for concurrent alexithymia in patients with chronic obstructive pulmonary disease(COPD). Methods A total of 842 patients with COPD were enrolled in a cross-sectional survey to collect sociodemographic characteristics, behavioral risk factors, as well as dyspnea, alexithymia, anxiety, depression and quality of life. Toronto Alexithymia Scale(TAS-20)was used to evaluate alexithymia, and lung function was tested. Risk factors related to COPD patients with alexithymia were identified by logistic regression analysis. Results The prevalence of alexithymia in COPD patients was 23.6%(199/842). Compared with the COPD group, the proportions of male, smoking, FEV₁% predictive value, HADS-A score, HADS-D score, SGRQ score and mMRC rating were higher in the group with alexithymia(P<0.05). The age, BMI and course of disease were relatively small or short, and the differences were statistically significant(P<0.05). Multivariate analysis showed that FEV₁% predictive value, HADS-A, HADS-D, mMRC and SGRQ were independent risk factors of COPD with alexithymia. Their OR values and corresponding 95CI% were 1.296(1.256-1.337), 1.238(1.097-1.396), 1.178(1.034-1.340), 1.297(1.274-1.320), 1.627(1.401-1.890), respectively. While age and BMI were protective factors of COPD with alexithymia. The OR were 0.886(0.794-0.998), 0.879(0.781-0.989), respectively. Conclusion COPD patients with alexithymia have worse lung function and quality of life. FEV₁% predictive value, HADS-A, HADS-D, mMRC and SGRQ scores are independent risk factors of COPD with alexithymia.