Influencing Factors Of Anxiety And Depression In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:By analyzing the prevalence of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease,the correlation between anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease and blood routine,lung function,blood gas and general information,etc.To provide a theoretical basis for improving the quality of life of patients with AECOPD.Methods:?1?According to the inclusion criteria and exclusion criteria,this study selected 62 AECOPD inpatients from January 2018 to January 2019 from the Department of Respiration,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University.The patients were divided into four groups according to Hamilton Anxiety and Depression Rating Scale score.Namely:AECOPD combined with anxiety and depression group,AECOPD combined with anxiety group,AECOPD combined with depression group and AECOPD group.?2?Collect the clinical data of each patient,including sex,age,smoking history,course of illness and the frequency of acute exacerbations in the previous year;enquire whether there are chronic diseases such as hypertension and coronary heart disease in stable stage;evaluate the quality of life?COPD assessment test,CAT?CAT score for COPD patients;detect arterial blood gas analysis on admission day:Arterial partial pressure of oxygen?PaO₂?;Inflammatory indicators:C-reactive protein?CRP?,high-sensitivity C-reactive protein?hs-CRP?,serum procalcitonin?PCT?;pulmonary function tests were performed within 3 days of admission to record the patient's forced expiratory volume in one second?FEV₁?,forced vital capacity?FVC?,one second rate?FEV₁/FVC?.?3?Analyze the statistic differences in the clinical data between AECOPD with anxiety and depression group and simple AECOPD group,AECOPD with anxiety group and simple AECOPD group repectively;Secondly,Pearson correlation test was conducted to determine whether the related variables were linearly related to AECOPD with anxiety and depression disorder.so as to preliminarily determine the possible impact of AECOPD patients with anxiety and depression or AECOPD patients with simple anxiety related factors.Results:?1?Among the 62 patients with AECOPD,13 patients?20.9%?were complicated with anxiety alone,no patients 0?0%?with depression alone,18 patients?29.0%?were complicated with anxiety and depression,and 31?50.0%?had no anxiety and depression.?2?The level of CRP in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with anxiety and depression was?52.24+37.11?mg/l,which was significantly higher than that in patients with AECOPD?41.68+32.88?mg/l.There was a statistical difference between the two groups?P<0.05?.The CAT score in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with anxiety and depression was?23+7.1?,while that in patients with AECOPD was?17+5.7?.The CAT score of acute exacerbation of chronic obstructive pulmonary disease complicated with anxiety and depression was significantly higher than that of simple AECOPD group,and there was statistical difference between the two groups?P<0.05?;similarly,the number of acute exacerbations in the previous year in the group of AECOPD combined with anxiety and depression was?3.22+0.52?times,which was higher than that in the group of non-anxiety and depression?1.83+0.14?,and there was statistical difference between the two groups?P<0.05?.The forced expiratory volume?FEV₁?of AECOPD combined with anxiety and depression group was significantly reduced to?1.06+0.51?L and that of AECOPD group was?1.40+0.48?L,there was statistical difference between the two groups?P<0.05?;the PaO₂ index of anxiety and depression group was?65.44+15.29?mmHg,which was significantly lower than?77.93+12.51?mmHg of non-anxiety and depression group,there was statistical difference?P<0.05?.There was no significant correlation between the two groups in sex,age,smoking history,FVC,PCT and course of disease?P>0.05?.?3?Acute exacerbation of chronic obstructive pulmonary disease with anxiety in the acute exacerbation period was?3.22+0.52?times in the previous year,and?1.83+0.14?times in the non-anxiety and depression group in the previous year.The data of the two groups were also statistically different?P<0.05?.?4?The overall CAT score of 62 patients with acute exacerbation of chronic obstructive pulmonary disease was correlated with PaO₂.The overall CAT score of patients was negatively correlated with PaO₂,and the correlation coefficient r=-0.284,P=0.048?P<0.05?.In the group with anxiety and depression,the correlation between CAT score and PaO₂ was not significant.Conclusions:1.Patients with acute exacerbation of chronic obstructive pulmonary disease are prone to anxiety and depression,and the occurrence of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease may be related to CRP,CAT,the number of acute exacerbations in the previous year,FEV₁,arterial partial pressure of oxygen.2.The occurrence of anxiety disorder in patients with acute exacerbation of chronic obstructive pulmonary disease is related to the number of acute exacerbations in the previous year.4.Acute exacerbation of chronic obstructive pulmonary disease with or without anxiety and depression,there is a significant correlation between the increase of respiratory-related CAT symptom score and the decrease of PaO₂,suggesting that the severity of symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease is closely related to the degree of hypoxia.