Wang Gang, Wang Lei, Szczepaniak William S, Xiong Ze-Yu, Wang Lan, Zhou Ting, Fu Juan-Juan, Liang Bing-Miao, Yuan Yu-Ru, Li Tao, Ji Yu-Lin
Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
J Asthma. 2010 Feb;47(1):93-9. doi: 10.3109/02770900903331119.
Airway hyperresponsiveness (AHR) is the characteristic functional abnormality of asthma, and previous studies have shown the potential for AHR to be influenced by psychological factors, yet the relationship between anxiety and/or depression and AHR remains unclear in patients with asthma.
To explore the relationship between psychological status and AHR in asthma patients.
In a cross-sectional study, 168 adult subjects were recruited with physician-diagnosed uncontrolled asthma and a positive result for AHR in methacholine (Mch) challenge test. Psychological status, asthma control, and asthma quality of life were assessed using Zung self-rating anxiety/depression scale, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ), respectively. AHR severity was evaluated and quantified by the provocative concentration of Mch, which evoked a given decrease of 20% in FEV(1).
A total of 70.23% of recruited patients (n = 118) met the diagnostic criteria for anxiety and/or depression. There was a trend between negative psychological status and AHR in asthma patients that did not reach statistical significance, but no independent effects of negative mood states (anxiety, depression, or both) on AHR were established. Further, analyses revealed that only anxiety is associated with worse asthma control (p = 0.029), and a significant interaction effect of depression and anxiety accounted for lower asthma-related quality-of-life scores (p < 0.001).
AHR and psychological status are loosely related to each other even if in uncontrolled asthma.
气道高反应性（AHR）是哮喘的特征性功能异常，既往研究表明AHR有可能受到心理因素的影响，但哮喘患者中焦虑和/或抑郁与AHR之间的关系仍不明确。
探讨哮喘患者心理状态与AHR之间的关系。
在一项横断面研究中，招募了168名成年受试者，这些受试者经医生诊断为未控制的哮喘，且在乙酰甲胆碱（Mch）激发试验中AHR呈阳性。分别使用zung自评焦虑/抑郁量表、哮喘控制测试（ACT）和哮喘生活质量问卷（AQLQ）评估心理状态、哮喘控制情况和哮喘生活质量。通过使第一秒用力呼气容积（FEV1）下降20%的Mch激发浓度来评估和量化AHR严重程度。
共有70.23%的招募患者（n = 118）符合焦虑和/或抑郁的诊断标准。哮喘患者的负面心理状态与AHR之间存在一种未达到统计学意义的趋势，但未确定负面情绪状态（焦虑、抑郁或两者兼有）对AHR有独立影响。此外，分析显示只有焦虑与更差的哮喘控制相关（p = 0.029），抑郁和焦虑的显著交互作用导致哮喘相关生活质量得分更低（p < 0.001）。
即使在未控制的哮喘中，AHR与心理状态之间的关系也较为松散。
