慢性阻塞性肺疾病患者合并抑郁、焦虑症的相关因素研究

发布时间：2018-06-01 01:20

本文选题：抑郁 + 焦虑　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的通过汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA量表)和汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD量表)及患者的相关临床表现对慢阻肺患者合并抑郁、焦虑症的状况进行了解,并收集患者的相关资料,探索慢阻肺患者合并抑郁、焦虑症的特点。方法收集经肺功能明确诊断的且符合入组标准的慢性阻塞性肺疾病住院患者91例,量表专业测评人员和精神科专科医师的对入组患者合并抑郁、焦虑症的情况、HAMA和HAMD量表的评分进行了了解,专科医师对合并抑郁症的慢阻肺患者进行了抑郁症亚型的分型。本研究收集了患者的性别、年龄、学历、吸烟史情况、身高、体重、病史情况等资料,完善了稳定期肺功能检测,对其中的67名患者进行了血清C反应蛋白水平的检测,通过Elisa染色法对其中的53患者进行了血清IL-6、IL-8、TNF-α水平的检测。分析在按照不同分组依据下,各组患者HAMA量表、HAMD量表评分的差异,并将患者分别按照是否合并抑郁、焦虑症进行分组,探讨慢阻肺患者合并抑郁、焦虑症的高危因素。同时,根据对合并抑郁症的慢阻肺患者进行抑郁症亚型的分型,将患者根据其合并的抑郁症亚型分为四组。通过与不合并抑郁症的慢阻肺患者对比,分析合并各种抑郁症亚型的慢阻肺患者的特点。结果在慢阻肺患者中,男性、有大量吸烟史、中学以上文化程度、慢性咳嗽时间长的慢阻肺患者的HAMA量表评分高于其他患者,慢性咳嗽时间长、慢性气喘时间长、有大量吸烟史、中学以上文化程度的慢阻肺患者的HAMD量表评分要高于其他患者。合并抑郁、焦虑症的慢阻肺患者多为男性、有大量吸烟史、文化程度相对较高、慢性咳嗽时间长,且合并抑郁症的慢阻肺患者的血清CRP水平高于不合并抑郁症的慢阻肺患者。相对较高的文化程度是慢阻肺患者合并抑郁、焦虑症的高危因素。合并各种抑郁症亚型的慢阻肺患者的特点是不同的。结论慢阻肺患者中合并抑郁焦、焦虑症的比例较高,不同患者合并抑郁、焦虑症的特点不同,合并不同抑郁症亚型的慢阻肺患者的特点也不同。临床医生可以根据这些特征,及时的了解慢阻肺患者合并抑郁、焦虑症的情况,尽早的进行干预,改善患者的治疗依从性,从而改善预后。
[Abstract]:Objective to investigate the status of depression and anxiety in patients with chronic obstructive pulmonary disease (COPD) by Hamilton Anxiety scale (Hama) and Hamilton Depression scale (Hamd) and their clinical manifestations, and to collect the relevant data of the patients. To explore the characteristics of depression and anxiety in patients with COPD. Methods 91 inpatients with chronic obstructive pulmonary disease (COPD) who were clearly diagnosed by pulmonary function and met the criteria of admission were collected. The scores of Hama and HAMD scale were used to understand the condition of anxiety disorder, and the subtypes of depression were classified by specialists in patients with chronic obstructive pulmonary disease (COPD) complicated with depression. The study collected the data of sex, age, education, smoking history, height, weight, medical history and so on, perfected the stable lung function test, and tested the serum C-reactive protein level in 67 patients. The serum levels of IL-6, IL-8 and TNF- 伪 were detected by Elisa staining in 53 of them. According to different groups, the differences of HAMA and Hamd scores were analyzed, and the high risk factors of depression and anxiety in patients with chronic obstructive pulmonary disease were discussed according to whether they were combined with depression or anxiety. At the same time, according to the subtypes of depression in COPD patients with depression, the patients were divided into four groups according to their depression subtypes. The characteristics of patients with chronic obstructive pulmonary disease (COPD) with various depression subtypes were analyzed by comparing with patients with chronic obstructive pulmonary disease (COPD) without depression. Results among the patients with chronic obstructive pulmonary disease (COPD), men had a large number of smoking history, education level above middle school, chronic cough long time, chronic cough time long, chronic asthma time long, chronic cough time was longer, chronic cough time was longer, Patients with chronic obstructive pulmonary disease (COPD) with high school education had higher HAMD scores than other patients with a large history of smoking. The COPD patients with depression and anxiety disorder were mostly male, had a large number of smoking history, higher education level, longer chronic cough time, and the serum CRP level of the COPD patients with depression was higher than that of the COPD patients without depression. A relatively high level of education is a risk factor for COPD patients with depression and anxiety disorder. The characteristics of COPD patients with various depression subtypes are different. Conclusion the proportion of depression and anxiety is higher in patients with chronic obstructive pulmonary disease. The characteristics of different patients with depression and anxiety disorder are different, and the characteristics of patients with chronic obstructive pulmonary disease with different depression subtypes are also different. According to these characteristics, the clinicians can understand the depression and anxiety in patients with COPD in time, intervene as soon as possible, improve the compliance of the patients and improve the prognosis.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9;R749

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