维生素D对慢性阻塞性肺疾病合并肺动脉高压患者焦虑、抑郁及生活质量的影响  

Effect of serum vitamin D on anxiety, depression and quality of life in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease

作　　者：符沙沙 陈宗存[2] 欧宗兴 周晓莉[1] 陈小庄[1] Sha-sha Fu;Zong-cun Chen;Zong-xing Ou;Xiao-li Zhou;Xiao-zhuang Chen(Department of Respiratory and Critical Care Medicine,Hainan General Hospital,Haikou,Hainan 570311,China;Department of Endocrinology,the Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China;Department of Respiratory,the Haikou Hospital Affiliated to Xiangya Medical College,Haikou,Hainan 570208,China)

机构地区：[1]海南省人民医院呼吸与危重症医学科,海南海口570311 [2]海南医学院第二附属医院内分泌科,海南海口570311 [3]中南大学湘雅医学院附属海口市人民医院呼吸内科,海南海口570208

出　　处：《中国现代医学杂志》2019年第14期60-64,共5页China Journal of Modern Medicine

基　　金：海南省自然科学基金(No:817386);海南省医药卫生科研项目(No:1301000320A1005);海南省卫生计生行业科研项目(No:16A200071)

摘　　要：目的探讨血清25-羟维生素D[25(OH)D]与慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者焦虑、抑郁及生活质量的关系。方法选取2015年1月—2018年3月海南省人民医院收治的182例稳定期COPD患者,收集患者年龄、性别、吸烟、体重指数(BMI)及第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)等基本情况。采用心脏彩超测肺动脉收缩压(PASP),根据PASP≥40mmHg分为COPD伴PH组(80例)和单纯COPD组(102例)。采用酶联免疫吸附法检测两组患者25(OH)D水平;采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及慢性阻塞性肺疾病评估测试问卷(CAT)分别评定两组患者焦虑、抑郁及生活质量情况。结果COPD伴PH组25(OH)D、HAMA、HAMD及CAT评分高于单纯COPD组(P<0.05)。25(OH)D缺乏组HAMA、HAMD及CAT评分高于25(OH)D正常组(P<0.05)。多元线性回归调整年龄、性别及BMI等混杂因素后,25(OH)D对COPD合并PH患者HAMD及CAT评分有负向影响(P<0.05)。结论血清25(OH)D水平与COPD合并PH患者抑郁及生活质量密切相关。Objective To investigate the relationship between serum 25- hydroxyvitamin D [25 (OH) D] and anxiety, depression and quality of life in patients with pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD). Methods A total of 182 patients were enrolled in this study. The patients were divided into COPD group (80 cases) and COPD combined with PH group (102 cases ) according to pulmonary artery systolic pressure (PASP)≥40 mmHg measured by echocardiography. The age, gender, smoking, body mass index (BMI), forced expiratory volume in the first second accounted for the percentage of forced vital capacity (FEV1/FVC) and so on were collected. Serum levels of 25 (OH) D was measured by ELISA. The Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD) and the chronic obstructive pulmonary disease assessment test questionnaire (CAT) were used to evaluate the anxiety, depression and quality of life of the two groups. Results The scores of 25 (OH) D, HAMA, HAMD and CAT in COPD with PH group were higher than those in COPD group (P < 0.05). The scores of HAMA, HAMD and CAT in 25 (OH) D deficiency group were higher than those in 25 (OH) D normal group (P < 0.05). After adjusting for age, sex and BMI by multiple linear regression, 25 (OH) D had a nega tive effect on HAMD and CAT scores in COPD patients with PH (P < 0.05). Conclusions Serum vitamin D was closely related to depression and quality of life in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease.

关 键 词：肺疾病 慢性阻塞性 高血压 肺性 焦虑 抑郁 生活质量 

分 类 号：R563.9[医药卫生—呼吸系统]