本文關(guān)鍵詞：慢性阻塞性肺疾病患者焦慮抑郁癥狀與BODE指數(shù)的相關(guān)性研究，由筆耕文化傳播整理發(fā)布。

        【目的】應(yīng)用慢性阻塞性肺疾病多維分級(jí)評(píng)分系統(tǒng)（BODE index)、醫(yī)院焦慮抑郁量表(HAD)綜合測評(píng)穩(wěn)定期慢性阻塞性肺疾病（COPD)患者，探索BODE指數(shù)與穩(wěn)定期COPD患者焦慮抑郁癥狀的相關(guān)性，為臨床評(píng)估COPD患者病情、預(yù)后及防治方法提供新的思路�！痉椒ā扛鶕�(jù)病史、臨床癥狀、體征及肺功能，選擇2010年4月1日至2012年3月30日在廣西醫(yī)科大學(xué)第一附屬醫(yī)院呼吸疾病研究所住院及慢性阻塞性肺疾病門診就診的186例穩(wěn)定期慢性阻塞性肺疾病患者為研究對(duì)象，進(jìn)行橫斷面調(diào)查。入選后①測量患者身高，體重；記錄吸煙包/年；測6分鐘步行距離(6MWD);采用英國醫(yī)學(xué)研究委員會(huì)呼吸困難量表（MRCdyspned scale)記錄氣促分級(jí)并評(píng)分；測量肺功能，，進(jìn)行BODE多維分級(jí)系統(tǒng)評(píng)分；②采用醫(yī)院焦慮抑郁量表(HAD)進(jìn)行患者心理狀態(tài)評(píng)分；③評(píng)估COPD患者焦慮抑郁程度，分析COPD穩(wěn)定期患者BODE指數(shù)（體重指數(shù)；肺功能（FEV1%);6分鐘步行距離；呼吸困難評(píng)分）及各因子與焦慮或抑郁的相關(guān)性，調(diào)查何種指標(biāo)為最密切相關(guān)，探討潛在的焦慮抑郁預(yù)測因子；調(diào)査COPD病情嚴(yán)重程度各級(jí)分期及BODE指數(shù)各級(jí)分期中患者焦慮、抑郁癥狀的發(fā)生率�！窘Y(jié)果】(l)COPD患者焦慮抑郁程度：186例COPD穩(wěn)定期患者焦慮分?jǐn)?shù)為（7.8土4.73)分，77例（41.4%)有焦慮情緒（焦慮評(píng)分》8分），其中45例患者（24.2%)為輕度焦慮（評(píng)分8?：10分），32例患者（17.2%)有明確焦慮癥狀，為中重度焦慮（焦慮評(píng)分>11分）。186例COPD穩(wěn)定期患者抑郁分?jǐn)?shù)為（8.8±4.62)分，86例（46.2%)患者有抑郁情緒（抑郁評(píng)分>8分），其中35例（18.8%)患者為輕度抑郁（評(píng)分8?10分）；51例（27.4%)患者有明確抑郁癥狀，為中重度抑郁（抑郁評(píng)分>11分）。(2)COPD患者焦慮抑郁的影響因素：單因素相關(guān)分析及多因素回歸顯示，BODE總分及分項(xiàng)指標(biāo)中的呼吸困難指數(shù)與患者情緒障礙呈顯著正相關(guān)(K0.05);6分鐘步行距離(6MWD)與患者情緒障礙呈顯著負(fù)相關(guān)（K0.05)；肺功能（FEVl%pred)及營養(yǎng)狀況（BMI)對(duì)COPD患者焦慮抑郁的影響較小。性別、住院次數(shù)、合并癥數(shù)目、負(fù)性情緒史、焦慮抑郁共病等為COPD患者情緒障礙的危險(xiǎn)因素。(3)COPD患者焦慮、抑郁癥狀與BODE分級(jí)的關(guān)系：COPD患者焦慮抑郁癥狀隨著BODE指數(shù)分級(jí)增加而加重，且每級(jí)之間的差異有統(tǒng)計(jì)學(xué)意義；而COPD患者焦慮評(píng)分在"慢性阻塞性肺疾病全球倡議"（GOLD)分級(jí)中，層級(jí)之間無統(tǒng)計(jì)學(xué)差異；抑郁評(píng)分在GOLD分級(jí)中有統(tǒng)計(jì)學(xué)意義�！窘Y(jié)論】（1)焦慮抑郁癥狀在COPD患者中發(fā)病率較高，合并焦慮抑郁的COPD患者生活質(zhì)量較正常心理的COPD患者差；（2) BODE指數(shù)總分及其分項(xiàng)的6分鐘步行距離(6麗D)及呼吸困難指數(shù)是預(yù)測COPD患者焦慮抑郁的有效指標(biāo)。（3) BODE指數(shù)分級(jí)與以肺功能（FEV1%)為基礎(chǔ)的GOLD分級(jí)比較，前者與COPD患者焦慮抑郁相關(guān)度更高，BODE級(jí)數(shù)越高，焦慮抑郁癥狀越嚴(yán)重；而(GOLD)分級(jí)不能全面反映焦慮抑郁癥狀。

    Objective: Anxiety and depression are two of the most commonandmodifiable co-morbidities of chronic obstructive pulmonary disease (COPD)and have an independent effect on health and prognosis. FEVl%pred has beenshown to be a poor predictor of anxiety and depression. The body mass index,degree of airflow obstruction, dyspnea, and exercise capacity (BODE) index is amultidimensional assessment system which may predict health outcome inCOPD patients. The purpose of this study was to investigate the predictivevalidity of the BODE index for anxious and depressive symptoms in COPDpatients.Methods: This was a multicenter, prospective, cross-sectional study in186patients with stable COPD. Anxious and depressive symptoms were assessedusing the Hospital Anxiety and Depression Scale (HADS). The relationshipsbetween anxiety, depression and potential predictors (including the BODE index)were analyzed by a binary Logistic regression model.Results: Subjects who had anxiety and depression, walked a shortersix-minute walking distance (6MWD), had more dyspnea, a higher BODE index,and lower health-related quality of life (P <0.05). Anxiety and depression score was significantly correlated with BODE(P<0.05). The prevalence ofanxiety and depression elevated with increasing BODE stage(P <0.05). On thebasis of binary Logistic regression, the BODE index was a good andindependent predictor of anxiety and depression because it compirsed dyspneaand6MWD, which were shown to be the main determinants.Conclusion:The predictive validity of the BODE index for anxiety and depression wasdemon-strated. We propose that the BODE index should be included inassessment of COPD severity.

        慢性阻塞性肺疾病患者焦慮抑郁癥狀與BODE指數(shù)的相關(guān)性研究

摘要4-6ABSTRACT6-7前言9-121 資料與方法12-162 結(jié)果16-333 討論33-45結(jié)論45-46參考文獻(xiàn)46-51附錄51-55綜述55-66    參考文獻(xiàn)62-66致謝66-67攻讀學(xué)位期間發(fā)表論文情況67

  本文關(guān)鍵詞：慢性阻塞性肺疾病患者焦慮抑郁癥狀與BODE指數(shù)的相關(guān)性研究，由筆耕文化傳播整理發(fā)布。