Study On Cognitive Function,anxiety And Depression In Patients With Chronic Obstructive Pulmonary Disease Without Hypoxemia

Objectives:This trial is intended to evaluate cognitive function,anxiety,depression and corresponding brain function in patients with chronic obstructive pulmonary disease without smoking with hypoxemia,and provide an objective basis for the overall management of COPD and physical and mental treatment of patients,and to reduce It plays a guiding role in the burden of disease families and improving the quality of life of patients.Methods:The 2017 GOLD guidelines were selected as the diagnostic inclusion criteria for 30 Han Chinese men in southwestern China,and those who met the COPD diagnosis and had a smoking history without a hypoxemia COPD group(group A).Group A inclusion criteria:Pulmonary function tests suggest forced expiratory volume/forced vital capacity(FEV1/FVC,one second rate)<70%after bronchodilator use and a symptomatic COPD diagnosis by a respiratory specialist,Such as chronic cough,difficulty breathing,etc.,smoking at least 10 per day for more than 5 years,but the arterial blood gas pressure(Pa02)?60mmHg.At the same time,30 age-and sex-matched right-handed healthy smokers were selected and the normal lung function was healthy smokers(group B).Exclusion criteria:left hand,magnetic resonance examination contraindications,history of respiratory diseases such as bronchial asthma,history of pulmonary surgery,history of central nervous system diseases,history of central nervous system-related drugs,hypertension,history of diabetes,history of basic mental illness,History of trauma,history of taking psychotropic substances,recent history of drug anesthesia,history of head trauma,history of alcohol or drug abuse.All patients with COPD underwent no changes to the original stable phase of treatment(including inhalation of LAB A and hormones).All the patients in the study included basic data and clinical indicators of all selected subjects:age,gender,education level,smoking index,BMI,lung function,duration of disease,arterial blood gas analysis without inhalation,MMSE,HAMD,HAMA.The enrolled patients underwent fMRI to observe whether the patient had the activation and inhibition of specific areas of brain function.Statistical analysis of all clinical data was performed using the SPSS 22.0(SPSS Inc.USA)software package.The basic description of the count data and the composition ratio were used.The normal distribution measurement data was expressed as mean±standard deviation,and the skewed distribution measurement data was used.The number of digits ± quartile spacing indicates that the two groups of age,body mass index,FEV1/FVC,HAMA,HAMD,PaO2,the normal distribution measurement data using group t test,the two groups of smoking index,education level,MMSE belongs to Non-normal distribution measurement data using non-parametric test(statistical threshold probability P is set to 0.05).The normal distribution measurement data uses Pearson Correlation Coefficients to test the correlation between two numerical variables.The skewed distribution measurement data uses spearnan to test the correlation between two numerical variables.At the same time,DPARSFA software was used for image statistical analysis,and the activation volume threshold was set to 10 voxels,that is,the meaningful brain regions were brain regions with continuous activation voxels above the above values.The correction was performed using the FDR correction method(False Discovery Rate),and P was set to 0.05(P value after correction)to evaluate the relationship between the neurological scale and brain function.Results:There was no significant difference in smoking index,age,years of education,smoking index,and BMI between group A and group B(p>0.05).The FEVI/FVC(%)and PaO2(mmHg)of group A patients were statistically different from those of group B(p<0.05).The MMSE,HAMA,and HAMD in group A were significantly different from those in group B(P<0.05),suggesting that patients in group A had a certain degree of cognitive dysfunction,anxiety and depression compared with group B.There was a statistically significant difference in the correlation between depression and anxiety in group A(P=0.008,t=0.447).There was no statistical significance in the correlation analysis between depression and anxiety in group B(P=0.322,t=0.187).Correlation analysis between MMSE and HAMD in group A was found to be statistically insignificant(p=0.901,t=0.024).Correlation analysis between MMSE and HAMD in group B was not statistically significant(p=0.537,t=0.107).MMSE and HAMA correlation analysis was performed in group A and found to be not statistically significant(p=0.992,t=-0.002).MMSE and HAMA correlation analysis was performed in group B and found to be not statistically significant(p=0.880,t=0.290).The brain function of group A and group B was found in the left and right cerebellar foot 1 area,left and right cerebellar 8 areas,left and right inferior temporal gyrus,left and right cerebellar foot 2 area,left and right fusiform gyrus,left and right sacral middle,left and right hippocampus,left and right cerebellum 9 area,left and right sacral middle back bungee,left and right cerebellum 7b area,left cerebellar foot 1 area,left The area of the cerebellar foot 2,the left and right hippocampus,the left and right cerebellum 4,5,the cerebellar sacral 8 area,the left amygdala brain area is different.Correlation analysis was performed between MMSE,HAMA,and HAMD in patients with different brain regions and group A.After the correlation analysis between MMSE and the differential brain area.it was suggested that the left occipital gyrus and the left occipital gyrus were negatively correlated with MMSE.After correlation analysis between HAMD and differential brain regions,it was suggested that the right nucleus was negatively correlated with HAMD.Correlation analysis between HAMA and different brain regions indicated that the right momental cleft and surrounding cortex,left lateral rupture and peripheral cortex,right lingual gyrus,left wedge and right wedge were positively correlated with patient HAMA.The right cerebellum 8 area,the left cerebellum 8 area,the right cerebellar foot 2 area,and the left cerebellar foot 2 area were negatively correlated with HAMA.Conclusions:1.Patients in group A had cognitive dysfunction,anxiety,and depression compared with group B.The correlation between anxiety and depression in group A was statistieally signifieant,suggesting that there may be interactions between the two.2.There are multiple brain function differences between group A and group B,which may help early diagnosis.3.After correlation analysis,patients' anxiety,depression,cognitive function and certain specific brain regions are closely related.Exploring the function of these brain regions may help the mechanism of the occurrence and development of physical and mental diseases.4.The above results provide an important basis for the early diagnosis and early intervention of COPD with cognitive dysfunction,anxiety,depression,and further study of the relationship between the symptoms and brain function and the mechanism may provide more help for the clinic.