摘要
目的分析北京市月坛社区卫生服务中心门诊就诊慢性阻塞性肺疾病(慢阻肺病)患者的焦虑、抑郁状况及其影响因素。方法该研究为横断面调查。采用便利抽样法, 选取2022年1月1日至2023年12月31日于月坛社区卫生服务中心门诊就诊的慢阻肺病患者进行肺功能检查, 指导患者填写问卷, 包括患者的人口学特征、慢阻肺病全球倡议(GOLD)分级标准、过去1年因急性加重导致住院的次数、改良版英国医学研究委员会呼吸困难问卷(mMRC评分)、慢阻肺病患者评估测试(CAT)评分、广泛性焦虑障碍量表(GAD-7)、患者健康问卷抑郁自评量表(PHQ-9), 用Logistic回归分析慢阻肺病患者的焦虑、抑郁状况及其相关影响因素。结果共纳入243例慢阻肺病患者, 男性74.1%(180/243), 年龄(67±9)岁。焦虑、抑郁的检出率分别为17.3%(42/243)、21.0%(51/243)。其中, 无焦虑、轻、中、重度焦虑者分别占82.7%(201/243)、11.1%(27/243)、4.6%(11/243)、1.6%(4/243);无抑郁、轻、中、中重、重度抑郁者分别占79.0%(192/243)、13.6%(33/243)、5.8%(14/243)、1.2%(3/243)、0.4%(1/243)。CAT评分31~40分(OR=26.621, 95%CI:4.451~159.209)、mMRC评分≥2级(OR=5.387, 95%CI:1.589~18.209)、GOLD分级≥3级(OR=3.227, 95%CI:1.205~8.645)、合并慢性病的种类≥1种(OR=8.571, 95%CI:1.132~64.920)、离婚/分居/丧偶(OR=3.125, 95%CI:1.369~7.136)、过去1年因急性加重导致住院的次数≥1次(OR=3.523, 95%CI:1.422~8.726)是慢阻肺病患者焦虑的影响因素(均P<0.05)。CAT评分≥21分(OR=3.326, 95%CI:1.038~10.653)、mMRC评分≥1级(OR=7.468, 95%CI:1.706~32.697)、GOLD分级≥3级(OR=3.160, 95%CI:1.225~8.148)、合并慢性病的种类≥1种(OR=5.624, 95%CI:1.295~24.422)、吸烟数≥40包·年(OR=2.689, 95%CI:1.092~6.623)、过去1年因急性加重导致住院的次数≥1次(OR=2.663, 95%CI:1.093~6.486)是慢阻肺病患者抑郁的影响因素(均P<0.05)。结论北京市月坛社区卫生服务中心门诊就诊慢阻肺病患者焦虑、抑郁检出率均较高。CAT评分、mMRC评分、GOLD分级、合并慢性病的种类、婚姻状况、过去1年因急性加重导致住院的次数是此类患者焦虑、抑郁的影响因素。
Objective To investigate the prevalence and associated factors of anxiety and depression in outpatients with chronic obstructive pulmonary disease(COPD)visiting the Yuetan Community Health Service Center in Beijing.Methods This cross-sectional study enrolled COPD patients who visited the center between January 1,2022,and December 31,2023,using convenience sampling.After pulmonary function tests,participants completed questionnaires covering demographic characteristics,GOLD classification,number of hospitalizations for acute exacerbations in the past year,modified Medical Research Council(mMRC)dyspnea scale score,COPD Assessment Test(CAT)score,Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9).The status and influencing factors of anxiety and depression were analyzed with univariate and multivariate Logistic regression.Results A total of 243 COPD patients were included,with 74.1%(180/243)being male and a mean age of 67±9 years.The prevalence rates of anxiety and depression were 17.3%(42/243)and 21.0%(51/243),respectively.Multivariate logistic regression analysis identified the following independent factors associated with anxiety(all P<0.05):CAT score 31-40(OR=26.621,95% CI:4.451-159.209),mMRC score≥2(OR=5.387,95%CI:1.589-18.209),GOLD grade≥3(OR=3.227,95% CI:1.205-8.645),presence of≥1 comorbidity(OR=8.571,95%CI:1.132-64.920),being divorced/separated/widowed(OR=3.125,95%CI:1.369-7.136),and≥1 hospitalization for acute exacerbation in the past year(OR=3.523,95% CI:1.422-8.726).Independent factors associated with depression(all P<0.05)were:CAT score≥21(OR=3.326,95% CI:1.038-10.653),mMRC score≥1(OR=7.468,95% CI:1.706-32.697),GOLD grade≥3(OR=3.160,95%CI:1.225-8.148),presence of≥1 comorbidity(OR=5.624,95% CI:1.295-24.422),smoking history≥40 pack-years(OR=2.689,95%CI:1.092-6.623),and≥1 hospitalization for acute exacerbation in the past year(OR=2.663,95% CI:1.093-6.486).Conclusion sThe prevalence of anxiety and depression among COPD outpatients in this Beijing community health center is considerable.CAT score,mMRC grade,GOLD grade,number of comorbidities,marital status,and history of hospitalization for acute exacerbation are risk factors of anxiety,while CAT score,mMRC grade,GOLD grade,number of comorbidities,smoking pack-years,and hospitalization history are risk factors for depression.
作者
徐立涛
蒋艳
郭珺
刘宬博
丁静
Xu Litao;Jiang Yan;Guo Jun;Liu Chengbo;Ding Jing(Yuetan Community Health Service Center,Fuxing Hospital,Capital Medical University,Xicheng District,Beijing 100032,China)
出处
《中华全科医师杂志》
2025年第12期1510-1517,共8页
Chinese Journal of General Practitioners
基金
北京市西城区卫生健康委员会科技新星项目(XWKX2022-18)。
关键词
肺疾病
慢性阻塞性
门诊医疗
焦虑
抑郁
Pulmonary disease,chronic obstructive
Ambulatory care
Anxiety
Depression
