Research The Status Of Anxiety And Depression And The Related Factors Among Patients With Chronic Obstructive Pulmonary Disease (COPD) At Stable

Objective:To Research the status and the related factors of anxiety and depression among patients with COPD at stable,and thus providing better information and basis for guiding the comprehensive treatment and improving the prognosis of patients with COPD.Method:200 stable COPD patients（the COPD group）and 100 healthy individuals（the control group）were selected and used the questionnaires to screen anxiety and depression.According to the standard of screening tools,evaluated the scores of anxiety and depression.Meanwhile acquired the general information and tested the pulmonary function.Detected the concentration of the serum Interleukin-6（IL-6）and Interleukin-18（IL-18）by double antibody sandwich avidinbiotincomplex-ELISA（ABC-ELISA）.Assessed the nutritional status with mini nutritional assessment（MNA）for each subjects and used the COPD Assessment Test（CAT）to assess the quality of life for COPD patients.SPSS17.0 software was used to analyze statistics.Results:There was no statistically significant difference between COPD group and healthy control group in general information,the two groups were comparable.The prevalence of anxiety and depression in COPD group was significantly higher than those in the control group,the difference was statistically significant.（2）In 200 cases of stable COPD patients,the prevalence of anxiety was 35%,the prevalence of depression was 10.5%,9.5%have anxiety and depression simultaneous.The pulmonary function index of FEV₁%in COPD patients without anxiety and depression was superior to COPD patients with anxiety and depression（P<0.05）,and with the increase of airflow limited degree,the prevalence of anxiety and depression increased also.The concentration of serum IL-6 in COPD patients without anxiety and depression were significantly lower than those with anxiety and depression（P<0.05）;The CAT score in COPD patients with anxiety and depression were obviously higher than those without anxiety and depression（P<0.05）,namely the quality of life in COPD patients with anxiety and depression were significantly worse than those without anxiety and depression;The MNA score of COPD patients with anxiety and depression were significantly lower than those without anxiety and depression（P<0.05）,namely the Nutritional status of COPD patients with anxiety and depression were worse than those without anxiety and depression.（3）Univariate logistic regression analysis showed that COPD patients with anxiety was related to the times of acute exacerbations one year before,medical payment method,CAT score,MNA score,depression,the serum level of IL-6,GOLD grade,FEV1%;COPD patients with depression was related to the times of acute exacerbations one year before,medical payment,CAT score,MNA score,anxiety,the serum level of IL-6,GOLD grade,body mass index,FEV₁%.（4）Multivariate logistic regression analysis found that the COPD patients with higher CAT score more easily combined anxiety（OR 1.342,95%CI 1.099 to 1.637）;The COPD patients with depression more easily combined anxiety（OR 17.238,95%CI2.858 to 104.023）;The COPD patients with less medical insurance reimbursement ratio more easily combined anxiety（OR 0.11,95%CI 0.046 to0.266）.The COPD patients with lower MNA score more easily combined depression（OR 0.852,95%CI 0.734 to 0.977）;The COPD patients with anxiety more easily combined depression（OR 16.852,95%CI 3.085 to 92.059）;The COPD patients with less medical insurance reimbursement ratio more easily combined depression（OR 0.345,95%CI 0.139 to 0.853）.Multivariate logistic regression analysis showed that the major factors related to the anxiety include CAT score,depression,medical payment method,the major factors related to the depression include MNA score,anxiety,medical payment method.Conclusion:（1）There is a high incidence of anxiety and depression state in stable COPD patients.Patients with stable COPD often occur anxiety and depression simultaneously.（2）COPD patients with anxiety was related to the times of acute exacerbations one year before,medical payment method,CAT score,MNA score,depression,the serum level of IL-6,GOLD grade,FEV₁%;COPD patients with depression was related to the times of acute exacerbations one year before,medical payment method,CAT score,MNA score,anxiety,the serum level of IL-6,GOLD grade,Body mass index,FEV₁%.（4）The independent risk factors for stable COPD patients with anxiety were low CAT scores,depression,less medical insurance reimbursement ratio.Low MNA scores,anxiety,less medical insurance reimbursement ratio were the independent risk factors for stable COPD patients with depression.