绵阳市COPD患者焦虑与抑郁检出情况及相关因素分析  

Detection situation of anxiety and depression and analysis of relative factors in patients with COPD in Mianyang

作　　者：弋可 曾强[2] 吴俊林[2] 唐雪莉 张任飞[2] 王金诚 夏俊杰[2] 邱宇[2] 刘学睿 卓丽华[2] 杨清平[2] 王开绿[2] 李文军[2] 刘艳群[2] 王蕾[2] 杨谨羽[2] 游婧秀 王娟[2] 王俊[3] 周晓英 樊继平 王刚 顾娇瑶 黄瑀 杜燕 肖肖 郭洪菊[6] 黄玲 Yi Ke;Zeng Qiang;Wu Junlin;Tang Xueli;Zhang Renfei;Wang Jincheng;Xia Junjie;Qiu Yu;Liu Xuerui;Zhuo Lihua;Yang Qingping;Wang Kailv;Li Wenjun;Liu Yanqun;Wang Lei;Yang Jinyu;You Jingxiu;Wang Juan;Wang Jun;Zhou Xiaoying;Fan Jiping;Wang Gang;Gu Jiaoya;Huang Yu;Du Yan;Xiao Xiao;Guo Hongju;Huang Ling(Southwest Medical University,Luzhou646000,China;The Third Hospital of Mianyang·Sichuan Mental Health Center,Mianyang621000,China;Jiangyou People's Hospital,Jiangyou621700,China;The Xiaojiangou Township Central Hospital of Youxian District in Mianyang,Mianyang621000,China;The Community Health Service Center of Fujiang street of Youxian District in Mianyang,Mianyang621000,China;The Chronic Disease Institute of Center for Controlling and Preventing Disease of Mianyang,Mianyang621000,China)

机构地区：[1]西南医科大学,四川泸州646000 [2]绵阳市第三人民医院.四川省精神卫生中心,四川绵阳621000 [3]江油市人民医院,四川江油621700 [4]绵阳市游仙区小枧沟中心卫生院,四川绵阳621000 [5]绵阳市游仙区涪江街道社区卫生服务中心,四川绵阳621000 [6]绵阳市疾病预防控制中心慢病预防控制所,四川绵阳621000

出　　处：《四川精神卫生》2018年第6期526-530,543,共6页Sichuan Mental Health

基　　金：四川省卫生和计划生育委员会科研课题(17PJ042)

摘　　要：目的了解绵阳市慢性阻塞性肺疾病(COPD)患者的心理卫生现状,为COPD患者的心理干预提供参考。方法采用分层整群随机抽样方法,在绵阳市抽取东材厂社区、紫阳村、江油昌明社区及江油南江村4个地点共1 116人为调查对象,将其中符合2017版慢性阻塞性肺疾病全球倡议(GOLD)诊断标准的91例COPD患者作为患者组,同期在上述4个地点选取80名肺功能正常的健康者为对照组。采用COPD评估测试(CAT)和改良的英国医学研究委员会呼吸困难量表评定患者组的生活质量和呼吸困难程度,用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表17项版(HAMD-17)评定两组的焦虑和抑郁症状。结果患者组焦虑和抑郁症状检出率分别为29. 7%、24. 2%;对照组焦虑和抑郁症状检出率分别为5. 0%、2. 5%;患者组焦虑和抑郁症状检出率均高于对照组(P均<0. 05)。在COPD患者中,焦虑组与非焦虑组的经济负担比较差异有统计学意义(P=0. 015),抑郁组与非抑郁组的m MRC评分和经济负担比较差异均有统计学意义(P均<0. 05)。结论对经流调筛查出的COPD患者,其可能存在焦虑和抑郁症状,性别和年龄可能是其发生焦虑的危险因素,CAT评分、m MRC评分、经济负担可能与其焦虑和抑郁无关。Objective To learn the mental health status of patients with chronic obstructive pulmonary disease(COPD)in Mianyang,and to provide references for psychological intervention for COPD patients.Methods 1116 subjects were selected using stratified cluster random sampling method which were from four sites(Dongcai factory community,Ziyang village,Jiangyou Changming community and Jiangyou Nanjiang village).Total 91 patients(patient group)with COPD who met the diagnostic criteria of 2017 Global Initiative for Chronic Obstructive Lung Disease(GOLD)were included in the survey.At the same time,80 healthy people with normal lung function were selected as the control group at the four sites mentioned above.The quality of life and the degree of dyspnea in patient group were assessed by the COPD Assessment Test(CAT)and modified British Medical Research Council Dyspnea Scale(mMRC).The symptoms of anxiety and depression were assessed by the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale-17 item,(HAMD-17).Results The detection rates of anxiety and depression symptom were 29.7%,24.2%respectively in patient group.In the control group,the detection rates of anxiety and depression symptom were 5.0%,2.5%.The detection rates of anxiety and depression symptom in the patient group were higher than those in the control group(all P<0.05).Among COPD patients,the difference of economic burden between the anxious group and the non-anxious group was statistically significant(P=0.015),and the differences of mMRC score and economic burden between the depressed group and the non-depressed group were statistically significant(all P<0.05).Conclusion Anxiety and depression may be present in patients with COPD who were screened by epidemiological survey,the gender and age may be the risk factors of anxiety for them.The CAT score,mMRC score and financial burden may be not related with anxiety and depression for them.

关 键 词：慢性阻塞性肺疾病 焦虑 抑郁 

分 类 号：R563[医药卫生—呼吸系统]