Current situation and influencing factors of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease
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目的 了解慢性阻塞性肺疾病(简称慢阻肺)急性加重患者焦虑抑郁现况,并分析相关影响因素.方法 对2022年8月-2023年10月入住安徽医科大学第二附属医院呼吸与危重症医学科的慢阻肺急性加重患者进行问卷调查.调查包括基本人口学信息、焦虑和抑郁评分、慢阻肺患者生活质量及呼吸困难症状,同时收集电子病历系统中患者的临床资料,根据焦虑或抑郁评分将慢阻肺患者分为焦虑组和无焦虑组或抑郁组和无抑郁组,比较组间各项观察指标并分析影响因素.结果 164例慢阻肺急性加重患者中,合并焦虑的患者123例(75.0％),合并抑郁的患者125例(76.2％),同时合并焦虑抑郁有105例,占64.0％.受教育程度、居住地、月收入、吸烟指数、慢性阻塞性肺疾病评估测试(chronic obstructive pulmonary disease assessment test,CAT)评分与慢阻肺急性加重合并焦虑有关(均P＜0.05),其中较高的CAT评分是慢阻肺急性加重患者合并焦虑的独立危险因素.居住地、月收入、吸烟指数、CAT评分、改良英国医学研究委员会呼吸困难问卷分级、实际碳酸氢盐、中性粒细胞百分比(neutrophil percentage,NEU％)、淋巴细胞百分比(lymphocyte percentage,LYM％)、嗜碱性粒细胞百分比(basophile percentage,BASO％)、碱性磷酸酶、总二氧化碳浓度、中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板淋巴细胞比值(platelet to lymphocyte ratio,PLR)与慢阻肺急性加重合并抑郁有关(均P＜0.05),其中较高的CAT评分、PLR值是慢阻肺急性加重合并抑郁的独立危险因素.结论 慢阻肺急性加重患者中合并焦虑抑郁的患病率较高,影响因素有慢阻肺患者生活质量、呼吸困难症状、受教育程度、居住地、月收入、吸烟指数、酸碱平衡、NEU％、LYM％、BASO％、NLR和PLR等.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and analyze the related influencing factors.Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023.The survey included basic demographic information,anxiety and depression scores,quality of life and dyspnea symptoms in the AECOPD patients.The clinical data of patients in the electronic medical record system were also collected.According to the anxiety score or depression score,the patients were divided into an anxiety group and a non-anxiety group,or a depression group and a non-depression group.The indicators between two groups were compared and the influencing factors were analyzed.Results Among the 164 patients with AECOPD,123 patients(75.0％)were complicated with anxiety,125 patients(76.2％)were complicated with depression,and 105 patients(64.0％)were complicated with anxiety and depression.Education level,place of residence,monthly income,smoking index,and chronic obstructive pulmonary disease assessment test(CAT)score were associated with AECOPD and anxiety(P＜0.05).Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD.Residence,monthly income,smoking index,CAT score,modified British Medical Research Council(mMRC)dyspnea questionnaire rating,actual bicarbonate,neutrophilic granulocyte percentage(NEU％),lymphocyte percentage(LYM％),basophile percentage(BASO％),alkaline phosphatase,total carbon dioxide concentration,neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)were associated with AECOPD and depression(P＜0.05).Among them,higher CAT score and PLR value were independent risk factors of AECOPD and depression.Conclusion Anxiety and depression have higher prevalence in AECOPD patients,and the influencing factors include quality of life,dyspnea symptoms,education level,place of residence,monthly income,smoking index,acid base balance,NEU％,LYM％,BASO％,NLR和PLR,etc.
Acute exacerbation of chronic obstructive pulmonary diseaseanxietydepressionchronic obstructive pulmonary disease assessment testplatelet to lymphocyte ratio
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