我国中老年人抑郁症状与心肺疾病关联的前瞻性队列研究  

Prospective cohort study of correlation between depressive symptoms and cardiopulmonary diseases among mid-aged and elderly in China

作　　者：蔺婧 孙俐 张馨予[1] 杨洪喜[1,3] 王耀刚 LIN Jing;SUN Li;ZHANG Xinyu;YANG Hongxi;WANG Yaogang(School of Public Health,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津医科大学公共卫生学院,天津300070 [2]天津医科大学护理学院 [3]天津医科大学基础医学院

出　　处：《中国慢性病预防与控制》2024年第2期81-85,89,共6页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金(71910107004,72004160);天津市科学技术局公共卫生科技重大专项(21ZXGWSY00090)。

摘　　要：目的探讨中国中老年人群抑郁症状与心肺疾病患病风险之间的关联,为心肺疾病的防治提供科学依据。方法数据来源于中国健康与养老追踪调查(CHARLS)。于2011年开展基线调查,采用10条目的流调中心抑郁量表(CESD-10)评估研究对象的抑郁症状,并收集人口社会学资料、体格检查、健康状况、生活方式等相关数据。心肺疾病结局数据来源于2018年随访数据,最终纳入研究对象8356名。使用R V.1.4统计软件,采用Cox比例风险模型分别分析中老年人抑郁症状对心血管疾病、慢性肺部疾病、仅患1种疾病以及心肺共病的影响。结果8356名研究对象中,基线时3608人(43.2%)有抑郁症状,2018年随访时心血管疾病患病846人(10.1%),慢性肺部疾病患病374人(4.5%),仅患1种疾病1046人(12.5%),心肺共病87人(1.0%)。调整混杂因素后,多因素Cox回归分析结果显示,与无抑郁症状的中老年人群相比,有抑郁症状与心血管疾病(HR=1.16,95%CI:1.01~1.33)、慢性肺部疾病(HR=1.41,95%CI:1.14~1.74)以及仅患1种疾病(HR=1.29,95%CI:1.14~1.47)高风险相关,均有统计学意义(P<0.05),而抑郁症状与心肺共病患病风险关联无统计学意义(P>0.05)。分层分析结果显示,与无抑郁症状的中老年人群相比,45~64岁(HR=1.24)、女性(HR=1.25)、初中及以上文化程度(HR=1.29)人群抑郁症状与心血管疾病高风险相关;45~64岁(HR=1.44)、男性(HR=1.48)、小学(HR=1.42)和初中及以上(HR=1.52)文化程度、城市(HR=1.44)人群抑郁症状与慢性肺部疾病高风险相关;45~64岁(HR=1.37)、男性(HR=1.22)、女性(HR=1.35)、小学(HR=1.31)和初中及以上(HR=1.44)文化程度、城市(HR=1.28)、农村(HR=1.42)人群抑郁症状与仅患1种疾病高风险相关,均有统计学意义(P<0.05,P<0.01)。不同特征人群抑郁症状与心肺共病之间关联无统计学意义(P>0.05)。结论抑郁症状是中老年人群心血管疾病、慢性肺部疾病的独立危险因素,而与心肺�Objective To explore the association between depressive symptoms and cardiopulmonary diseases among middle-aged and elderly people in China,and provide the scientific basis for the prevention and treatment of cardiopulmonary diseases.Methods The data were from China Health and Retirement Longitudinal Study(CHARLS).In 2011,the baseline investigation was performed with the 10-item Center for Epidemiologic studies Depression Scale(CESD-10)to evaluate the depressive symptoms of the subjects,and the related data of demographic sociological,physical examination,health status,and lifestyle were collected.Cardiopulmonary disease outcome data were from follow-up data in 2018,and 8356 subjects were finally included.Cox proportional hazards regression models were performed to analyze respectively the influence of depressive symptoms on cardiovascular disease,chronic pulmonary diseases,only one type of diseases or cardiopulmonary comorbidity among mid-aged and elderly.The used software was R V.1.4.Results Among 8356 subjects,there were 3608 cases(43.2%)with depressive symptoms at baseline investigation;in 2018,during the follow-up,there were 846 cases(10.1%)with cardiovascular disease,374 cases(4.5%)with chronic pulmonary disease,1046 cases(12.5%)with just only one disease,and 87 cases(1.0%)with cardiopulmonary comorbidity.The results of the Cox model showed that after adjusting confounding factors,compared with those mid-aged and elderly people without depressive symptoms,the depressive symptoms were related to the high risk of cardiovascular disease(HR=1.16,95%CI:1.01-1.33),chronic pulmonary disease(HR=1.41,95%CI:1.14-1.74),just only one disease(HR=1.29,95%CI:1.14-1.47),respectively(P<0.05).But the depressive symptoms were not related with the risk of cardiopulmonary comorbidity(P>0.05).The stratified analysis results indicated that as compared with the middle-aged and elderly population without depressive symptoms,depressive symptoms were related with high risk of cardiovascular disease among the 45-64 years old group(HR=

关 键 词：心血管疾病 慢性肺部疾病 心肺共病 抑郁症状 中老年人群 

分 类 号：R749.4[医药卫生—神经病学与精神病学]