摘要
目的采用Meta分析法探讨慢性阻塞性肺疾病(COPD)患者焦虑、抑郁发生率及其影响因素。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、CINAHL、Wiley中公开发表的关于COPD患者焦虑、抑郁发生率及其影响因素的文献,检索时限为2014年1月—2024年9月。采用RevMan 5.3软件进行Meta分析,采用敏感性分析探讨异质性来源。结果最终纳入文献31篇,共包含7983例患者,其中伴有焦虑965例、伴有抑郁2228例。Meta分析结果显示,COPD患者焦虑、抑郁发生率分别为36%[95%CI(28%~45%)]、36%[95%CI(26%~46%)]。亚组分析结果显示:按发表年份分组,2014—2018年COPD患者焦虑、抑郁发生率分别为40%、39%,2019年1月—2024年9月COPD患者焦虑、抑郁发生率均为32%;按国家分组,中国COPD患者焦虑、抑郁发生率分别为40%、39%,其他国家COPD患者焦虑、抑郁发生率分别为23%、31%;按年龄分组,<65岁的COPD患者焦虑、抑郁发生率分别为38%、28%,≥65岁的COPD患者焦虑、抑郁发生率分别为34%、41%;按性别分组,男性COPD患者焦虑、抑郁发生率分别为74%、71%,女性COPD患者焦虑、抑郁发生率分别为26%、29%。Meta分析结果显示,改良版英国医学研究会呼吸问卷(mMRC)评分、慢性阻塞性肺疾病评估测试(CAT)评分、急性加重次数、受教育程度是COPD患者发生焦虑的影响因素(P<0.05);急性加重次数、GOLD分级、CAT评分、BODE、吸烟、病程、家庭支持、受教育程度是COPD患者发生抑郁的影响因素(P<0.05)。结论基于现有证据表明,近十年COPD患者焦虑、抑郁发生率均为36%。急性加重次数、CAT评分和受教育程度是COPD患者发生焦虑、抑郁的共同影响因素,mMRC评分是其发生焦虑的影响因素,GOLD分级、BODE、吸烟、病程和家庭支持是其发生抑郁的影响因素。
Objective To explore the incidence of anxiety and depression and their influencing factors in patients with chronic obstructive pulmonary disease(COPD)by meta-analysis.Methods The literature on the incidence of anxiety and depression and its influencing factors in patients with COPD were retrieved by computer in CNKI,Wanfang Data,VIP,CBM,PubMed,Web of Science,Cochrane Library,CINAHL and Wiley from January 2014 to September 2024.RevMan 5.3 software was used for meta-analysis,and sensitivity analysis was used to explore the sources of heterogeneity.Results A total of 31 articles were included,including 7983 patients,of which 965 cases were accompanied by anxiety and 2228 cases were accompanied by depression.Meta-analysis results showed that the overall incidence of anxiety and depression in patients with COPD was 36%[95%CI(28%-45%)],36%[95%CI(26%-46%)],respectively.Subgroup analysis showed that:grouped by publication year,the overall incidence of anxiety and depression in patients with COPD in 2014-2018 were 40%,39%,respectively;the overall incidence of anxiety and depression in patients with COPD from January 2019 to September 2024 all were 32%.Grouped by country,the overall incidence of anxiety and depression in patients with COPD in China were 40%,39%,respectively;the overall incidence of anxiety and depression in patients with COPD in other countries were 23%,31%,respectively.Grouped by age,the overall incidence of anxiety and depression in COPD patients with aged<65 years old were 38%,28%,respectively;the overall incidence of anxiety and depression in COPD patients with aged≥65 years old were 34%,41%,respectively.Grouped by gender,the overall incidence of anxiety and depression in male patients with COPD were 74%,71%,respectively;the overall incidence of anxiety and depression in female patients with COPD were 26%,29%,respectively.The results of meta-analysis showed that modified British Medical Research Council(mMRC)score,Chronic Obstructive Pulmonary Disease Assessment Test(CAT)score,the number of acute exacerbation and education level were the influencing factors of anxiety in patients with COPD(P<0.05).The number of acute exacerbation,GOLD classification,CAT score,BODE,smoking,course of disease,family support and education level were the influencing factors of depression in patients with COPD(P<0.05).Conclusion Based on the existing evidence,the incidence of anxiety and depression in patients with COPD in the past ten years are 36%.The number of acute exacerbation,CAT score and education level are the common influencing factors of anxiety and depression in patients with COPD.The mMRC score is the influencing factor of anxiety of them,and the GOLD classification,BODE,smoking,course of disease and family support are the influencing factors of depression of them.
作者
陈虹辛
雒甜甜
陈立夏
徐静
常梦婷
程喜荣
CHEN Hongxin;LUO Tiantian;CHEN Lixia;XU Jing;CHANG Mengting;CHENG Xirong(Nursing Department,the Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,China;School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China)
出处
《实用心脑肺血管病杂志》
2025年第8期25-33,共9页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
老年长期照护教育部重点实验室开放基金项目(LNYBPY-2023-21)
2024年江苏省研究生培养创新工程研究生科研与实践创新计划项目(SJCX24_0852)。
关键词
肺疾病
慢性阻塞性
焦虑
抑郁
影响因素分析
META分析
Pulmonary disease,chronic obstructive
Anxiety
Depression
Root cause analysis
Meta-analysis
