老年男性慢性阻塞性肺疾病合并焦虑抑郁状态临床研究

目的 通过对老年男性慢性阻塞性肺疾病(COPD)患者伴随焦虑抑郁状态发病率及临床资料分析,探讨影响其发生的相关因素,从而为COPD伴随焦虑抑郁状态的临床诊治提供帮助.方法 选取符合COPD诊断标准的老年男性急性发作期(AECOPD)住院患者38例,进行汉密尔顿焦虑抑郁量表问卷调查.结果 老年男性AECOPD合并焦虑抑郁状态发生率较高(18/38,47.4％),AECOPD合并焦虑抑郁组COPD评估测试(CAT)评分、改良英国MRC呼吸困难指数(MMRC)分级、前1年急性加重次数及C反应蛋白(CRP)水平高于无焦虑抑郁组(P＜0.05),第1秒用力呼气容积占预计值百分比(FEV1％ pred)(35.78±17.25)％ vs (50.91±20.00)％]、第1秒用力呼气容积(FEV1)与用力肺活量(FVC)比值(FEV1/FVC) (35.78±17.25)％ vs (50.91±20.00)％低于无焦虑抑郁组(P＜0.05),而两组在年龄、体质量指数、吸烟指数、戒烟年限、COPD病程、本次住院时间及血气分析方面差异无统计学意义(P＞0.05).结论 老年男性AECOPD容易合并焦虑抑郁状态.老年男性AECOPD合并焦虑抑郁状态与肺功能受损程度、CAT评分、MMRC分级、前1年急性加重次数有关.老年男性AECOPD合并焦虑抑郁状态的患者CRP水平明显增加,说明COPD合并焦虑抑郁可能与炎症反应有关.

Clinical study on elderly male patients of chronic obstructive pulmonary disease with anxiety and depression

Objective The aim is to investigate anxiety and depression in elderly male patients with chronic obstructive pulmonary disease（COPD） by analyzing the clinical data, and thus providing better guidance for clinical diagnosis and treatment. Methods According to the inclusion and exclusion criteria, the selection included acute exacerbation COPD（AECOPD） hospitalized elderly （age ≥ 60 years） male patients in 38 cases, using the Hamilton anxiety,depression scale to determine whether the patients had symptoms of anxiety and depression, to observe the incidence of the anxiety and depression, meanwhile, all the selected patients were divided into anxiety and depression group and without anxiety and depression group. Results There were 18 cases with anxiety and/or depression in 38 AECOPD patients, accounting for 47.4%, COPD with anxiety and depression group CAT score, MMRC classification, the times of acute exacerbation,one year before C reactive protein（CRP） were higher than those without depression and anxiety group（ P 〈 0.05 ）, FEV1% Pred （ 35.78 ± 17.25 ） % vs （ 50.91 ±20.00） %, FEV1/FVC （ 35.78 ± 17.25 ） % vs （50.91±20.00） % were lower than those without depression and anxiety group （ P 〈0.05）, but the two groups in age, body mass index, smoking index, age, smoking, blood gas analysis course of chronic obstructive pulmonary disease had no significalat difference （ P 〈0.05）. Conclusion The elderly male patients in AECOPD combined with anxiety and depression easily. The elderly male patients in AECOPD combined with anxiety depression related to the level of lung function,CAT score, MMRC score,the times of acute exacerbation one year before. The level of CRP increased in patients with AECOPD combined with depression and anxiety,the level of CRP is associated with airway inflammation injury, indicating that the patients with COPD combined with anxiety and depression may be associated with inflammation reaction.