本文選題：抑郁 + 焦慮　； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的通過漢密爾頓焦慮量表(Hamilton Anxiety Scale,HAMA量表)和漢密爾頓抑郁量表(Hamilton Depression Scale,HAMD量表)及患者的相關臨床表現(xiàn)對慢阻肺患者合并抑郁、焦慮癥的狀況進行了解,并收集患者的相關資料,探索慢阻肺患者合并抑郁、焦慮癥的特點。方法收集經(jīng)肺功能明確診斷的且符合入組標準的慢性阻塞性肺疾病住院患者91例,量表專業(yè)測評人員和精神科�？漆t(yī)師的對入組患者合并抑郁、焦慮癥的情況、HAMA和HAMD量表的評分進行了了解,�？漆t(yī)師對合并抑郁癥的慢阻肺患者進行了抑郁癥亞型的分型。本研究收集了患者的性別、年齡、學歷、吸煙史情況、身高、體重、病史情況等資料,完善了穩(wěn)定期肺功能檢測,對其中的67名患者進行了血清C反應蛋白水平的檢測,通過Elisa染色法對其中的53患者進行了血清IL-6、IL-8、TNF-α水平的檢測。分析在按照不同分組依據(jù)下,各組患者HAMA量表、HAMD量表評分的差異,并將患者分別按照是否合并抑郁、焦慮癥進行分組,探討慢阻肺患者合并抑郁、焦慮癥的高危因素。同時,根據(jù)對合并抑郁癥的慢阻肺患者進行抑郁癥亞型的分型,將患者根據(jù)其合并的抑郁癥亞型分為四組。通過與不合并抑郁癥的慢阻肺患者對比,分析合并各種抑郁癥亞型的慢阻肺患者的特點。結(jié)果在慢阻肺患者中,男性、有大量吸煙史、中學以上文化程度、慢性咳嗽時間長的慢阻肺患者的HAMA量表評分高于其他患者,慢性咳嗽時間長、慢性氣喘時間長、有大量吸煙史、中學以上文化程度的慢阻肺患者的HAMD量表評分要高于其他患者。合并抑郁、焦慮癥的慢阻肺患者多為男性、有大量吸煙史、文化程度相對較高、慢性咳嗽時間長,且合并抑郁癥的慢阻肺患者的血清CRP水平高于不合并抑郁癥的慢阻肺患者。相對較高的文化程度是慢阻肺患者合并抑郁、焦慮癥的高危因素。合并各種抑郁癥亞型的慢阻肺患者的特點是不同的。結(jié)論慢阻肺患者中合并抑郁焦、焦慮癥的比例較高,不同患者合并抑郁、焦慮癥的特點不同,合并不同抑郁癥亞型的慢阻肺患者的特點也不同。臨床醫(yī)生可以根據(jù)這些特征,及時的了解慢阻肺患者合并抑郁、焦慮癥的情況,盡早的進行干預,改善患者的治療依從性,從而改善預后。
[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- 偽 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.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R563.9;R749

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