Analysis Of Related Factors Of Anxiety In Patients With Chronic Obstructive Pulmonary Disease

Objective Anxiety is a common psychiatric complication in patients with chronic obstructive pulmonary disease（COPD）and is easily ignored by clinical medical workers and patients.In recent years,many scholars have shown that combined anxiety is closely related to poor treatment compliance,cognitive dysfunction,acute exacerbation,increased number of hospitalizations,and decreased survival rates in patients with COPD.In order to increase the attention of patients and front-line medical care to the mental integration of patients with COPD,and to improve the prognosis of COPD patients,as well as provide a preliminary reference for timely clinical diagnosis and early intervention,this study uses statistical analysis to understand the clinical characteristics of COPD patients with anxiety,and further explore the risk factors of COPD patients with anxiety.Methods In accordance with the inclusion and exclusion criteria,we included and analyzed 70 COPD patients admitted to the Third Affiliated Hospital of Anhui Medical University from October 2015 to October 2018.We collected clinical data such as lung function,chronic cough time,COPD assessment test,as well as whether with typeⅡrespiratory failure,and recorded socio-demographic data such as smoking history,age,height,weight,per capita household income,and education of the patient before discharge.Also a scale assessor who does not understand the patient’s condition completes the Hamilton Anxiety Scale（HAMA）score and Social Support Rate Scale score.The patients were divided into COPD group with anxiety and COPD group based on HAMA score.We used SPSS19.0 statistical software to analyze the differences of the above indicators between the two groups of patients,and clarify the clinical characteristics and risk factors of COPD patients with anxiety.Results There was no statistically significant difference in COPD patients with anxiety and COPD patients in gender,age,chronic cough time,BMI,Per capita household income,SSRS score and whether with typeⅡrespiratory failure（P>0.05）.There were statistically significant differences in smoking history,education background,FVC,FEV₁,FEV₁/FVC,FEV₁pred%and serum CRP between the two groups of patients（P<0.05）.The specific manifestation is that COPD patients who smoke heavily are more likely to develop anxiety disorders than patients who are mild and non-smokers（72.73%%vs46.15%）（P=0.026）;Patients with COPD who were educated were more likely to have anxiety than those who were not educated.[junior high school education or above vs primary education vs below primary school education（86.67%vs47.37%vs42.86%）]（P=0.002）].FVC,FEV₁,FEV₁/FVC,and FEV₁pred%of COPD patients with anxiety tend to be lower than those of the control group,[1.51（1.19,1.90）vs1.96（1.46,2.61）P=0.008]、（0.71（0.52,0.99）vs0.99（0.86,1.45）P=0.001）、[48.99（43.25,56.61）vs55.96（48.43,62.55）)P=0.009]、[49.35（36.55,56.03）vs 59.65（40.18,67.63）P=0.034];The CRP level in the anxiety group was higher than that in the control group[13.1（0.47,18.18）vs0.80（0.49,3.43）P=0.000];Univariate binary logistic regression analysis showed that smoking history,education,FVC,FEV₁,FEV₁/FVC,FEV₁pred%,and serum CRP were associated with anxiety in patients with COPD.Multivariate binary logistic regression analysis showed that low FEV₁,higher education and high levels of peripheral blood CRP were associated with anxiety disorders in patients with COPD.Conclusions Anxiety has a high incidence in patients with COPD.The clinical features of COPD patients with anxiety are heavy smoking,higher education（junior high school and above）,poor lung function such as low FVC,FEV₁,FEV₁/FVC,FEV₁pred%,and high serum CRP levels.Excluding colinearity,multivariate logistic regression analysis showed that the risk factors for COPD patients with anxiety were low FEV₁,higher education and high levels of peripheral blood CRP.