Study On The Correlation Between The Risk Factors,Symptoms Distribution And Inflammatory Cytokines Of Chronic Obstructive Pulmonary Disease With Depression And Anxiety

Objective: To evaluate the depression and anxiety symptoms of inpatients with COPD for studying the risk factors of COPD with depression and anxiety;To analyze the symptom distribution of COPD with depression and anxiety for providing new ideas for the diagnosis of clinical COPD with depression and anxiety;To detect IL-1 ?,IL-6 and TNF-? of the patients with COPD for exploring their correlation and possible diagnostic values in COPD combine with depression and anxiety.Methods: 123 patients with COPD who met the inclusion criteria and exclusion criteria were selected to collect the baseline data,lung function and blood gas analysis results.The chronic obstructive pulmonary disease assessment scale(CAT),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)were used to evaluate the patients with COPD.In the same period,27 depression and anxiety patients and 27 healthy people were collected according to the inclusion and exclusion criteria,and they were also assessed with the HAMD and HAMA;The serum levels of IL-1?,IL-6 and TNF-? were measured in peripheral venous blood.According to the evaluation results of the HAMD and HAMA,the patients with COPD were divided into two groups:COPD with depression and/or anxiety group and asymptomatic COPD group.The risk factors of depression and/or anxiety in COPD patients were analyzed by comparing the baseline data and clinical measurement data(spirometry,arterial blood gas analysis,and the CAT scale).The symptom distribution of COPD patients with depression and anxiety was compared with those of depression and anxiety patients.To compare the serum levels of inflammatory cytokines between the asymptomatic COPD group,the COPD group with depression and anxiety group,the depression and anxiety group and the healthy group for analyzing whether there is a correlation.SPSS24.0 was used to analyze the data.Results: Among the 123 COPD patients,61(49.6%)had no symptoms of anxiety and depression,62(50.4%)had depression and/or anxiety,and 27(21.9%)had depression and anxiety.Sex,smoking history,inhaled corticosteroids,number of acute exacerbations in the previous year,respiratory failure,duration of illness,the CAT score were correlated with depression and/or anxiety in COPD;There was no correlation among age,body mass index,home oxygen therapy and the GOLD grades.The CAT score and inhaled glucocorticoid were independent risk factors for COPD with depression and/or anxiety.When comparing the symptom distribution between COPD patients with depression and anxiety and those with depression and anxiety: In the comparison of Hamilton Anxiety Scale,the total score and mental anxiety factors of the depression and anxiety group were higher than the counterpart(p<0.05),but the physical anxiety factors had no statistically significant difference between them.In the comparison of Hamilton Depression Scale,however,there was no statistically significant difference in the total score of the Hamilton Depression Scale between the two groups(p>0.05).In the comparison of the scores of body weight factor and retardation factors,the COPD with depression and anxiety group were higher(p<0.05);In the comparison of day and night change factor and cognitive impairment factors,the depression and anxiety group was more obvious(p<0.05);There was no significant difference between the two groups in anxiety/somatization factor,sense of despair factors,and sleep disorder factors(p>0.05).Comparison of the four groups of inflammatory cytokines: The serum levels of IL-1?,IL-6 and TNF-? were significantly different among the four groups(p<0.05);The serum levels of IL-6 and TNF-? in COPD with depression and anxiety group and asymptomatic COPD group were statistically significant(p<0.05),and correlated with depression and anxiety symptoms,there was no significant difference in the serum level of IL-1? between the two COPD groups(p>0.05);There was significant difference in the serum levels of IL-1? and TNF-? between the depression and anxiety group and the health control group(p<0.05),which was correlated with depression and anxiety;there was no significant difference in the serum level of IL-6between the two groups(p>0.05).Conclusion: Depression and anxiety are common in COPD patients.In this study,half(50.4%)of COPD patients had symptoms of depression and/or anxiety.Sex,smoking history,inhaled glucocorticoid,number of acute exacerbations in the previous year,respiratory failure,duration of illness,the CAT score were closely related to depression and/or anxiety symptoms of COPD.The CAT score and and inhaled glucocorticoid were independent risk factors for COPD with depression and/or anxiety.As far as the distribution of depression and anxiety symptoms is concerned,patients with depression and anxiety have more severe mental anxiety symptoms and more typical mental depression symptoms.COPD with depression and anxiety,an emotional disorder that is dominated by physical depression and anxiety symptoms rather than a disease that is mainly mental depression and anxiety disorder.In most cases,it is strongly related to its own diseases and accompanying comorbidities.IL-6 and TNF-? were correlated with depression and anxiety in COPD,and have the diagnostic value.The correlation between IL-1? and depression and anxiety in COPD needs further study.