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

Purpose:By evaluating the anxiety and depression status of patients with Chronic Obstructive Pulmonary Disease(COPD),we identified the related risk factors of COPD with anxiety and depression.In addition,we collected the serum inflammatory factors,CPR and FIB,in COPD with anxiety and depression and evaluated its clinical diagnostic value,so as to provide assistance to clinical diagnosis and treatment.Methods:Based on the inclusion and exclusion criteria,we collected 142 cases of patients with COPD who admited to the respiratory and critical care medicine in the Fourth Affiliated Hospital Of Nan Chang University between January 2021 and December2021.We measured the numericalarterials of arterial blood gas analysis and peripheral blood C-reactive protein(C-reactive Protern,CRP),Fibrino-gen(detection of Fibrinogen,FIB)after all patients in stable condition.In addition,we evaluated patients with the COPD Assessment Test(CAT)、 modified Medical Research Council(m MRC)and Hospital Anxiety and Depression Scales(HADS)and Collected patients’ age,sex,Body Mass Index(BMI),education level,smoking history,COPD course length,number of acute exacerbation in the past 1 years,pulmonary function Index of six months,complications and et al.According to the presence of anxiety and depression was divided patients into simple COPD group and COPD with anxiety and /or depression group.we used SPSS25.0 to statistic and analysis the symptoms distribution characteristics and analysis CRP,FIB in COPD with anxiety and depression in two groups,to evaluate the early prediction and diagnosis value.Results:1.There were 142 cases in this study,54 cases(38%)were included in anxiety and/or depression with COPD group,88 cases(62%)were included in simple COPD group.2.Comparison of baseline data between the two groups: The BMI in COPD patients with anxiety and/or depression was significantly lower than that of patients with simple COPD [(21.19±0.48)VS(22.44±0.38),P<0.05];The incidence of anxiety and/or depression in smokers and quitters was significantly higher than that in non-smokers [22(57.9%)VS22(39.3%)VS 10(20.8%),P<0.05].The incidence of anxiety and/or depression in patients with smoking index greater≥400 years was higher than that in patients with smoking index <400 years[34 patients(46.6%)VS 20patients(29%),P<0.05].There were no significant differences in gender,age and education distribution between the two groups(P>0.05).3.Comparison of comorbidities and treatment schemes between the two groups:the incidence of anxiety and/or depression in COPD patients with ≥2 comorbidities was higher than that in patients with <2 comorbidities [46 patients(43%)VS 8patients(22.2%),P<0.05].There were no significant differences in the distribution of cardiovascular complications,home oxygen therapy,respiratory failure and inhaled glucocorticoids between the two groups(P>0.05).4.Comparison of disease characteristics between the two groups: the average CAT score of patients with anxiety and/or depression was higher than that of patients with simple COPD [21 points(18.00,22.00)VS19 points(14.25,21.00),P<0.05].The incidence of anxiety and/or depression in group C and D was higher than that in group A and B [11(68.8%)VS15(55.6%)VS 8(25.8%)VS 20(29.4%),P<0.05].There were no significant differences between the two groups in average COPD course length,the number of acute exacerbations in the past year and the grouping of m MRC score(P>0.05).5.Comparison of lung function indexes between the two groups: the mean FEV1 of patients with anxiety and/or depression was lower than that of patients with simple COPD [0.94(0.77,1.31)VS1.56(1.09,2.16),P<0.05].The mean FEV1pred% of patients with anxiety and/or depression was lower than that of patients with simple COPD [38.6(33.1,48.7)VS 65.4(55.8,85.8),P<0.05].The incidence of anxiety and/or depression in GOLDⅢ and GOLDⅣpatients was significantly higher than that in GOLDⅠand GOLDⅡpatients [8 patients(80%)VS 40 patients(87%)VS 6patients(10.3%)VS 0 patients(0%),P<0.05].6.Comparison of inflammatory indexes between the two groups: CRP in COPD patients with anxiety and/or depression was higher than that in COPD patients with simple COPD [9.35(3.89,28.33)VS 3.67(1.30,7.75),P<0.05],and there was no significant difference in FIB distribution between the two groups(P>0.05).7.Multivariate Logistic regression analysis showed that smoking(OR=0.188,CI95%= 0.062-0.566,P =0.003),increased GOLD grade(OR=0.041,CI95%= 0.009-0.181,P =0.000),increased CRP(OR= 0.980,CI95%=0.964～0.997,P =0.021)was an independent risk factor for COPD complicated with anxiety and/or depression.8.ROC curve showed that the best entry value of CRP for predicting COPD with anxiety and/or depression was 6.5mg/L,with the sensitivity of 66.7% and specificity of 75%.Conclusion:1.Anxiety and depression was common in COPD patients,smoking history,elevated CRP and GOLD were independent risk factors for anxiety and/or depression.2.CRP level may be an early predictor in forecasting COPD with anxiety and/or depression.