Wang Gang, Zhou Ting, Wang Lan, Wang Lei, Fu Juan-Juan, Zhang Hong-Ping, Ji Yu-Lin
Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, PR China.
J Asthma. 2011 Dec;48(10):1041-50. doi: 10.3109/02770903.2011.631238.
Subjects with asthma are more susceptible to psychological symptoms, but it is uncertain whether psychological symptoms are linked to future risk of asthma outcomes.
To investigate the relationship between current psychological symptoms and future risk of asthma outcomes.
We conducted a prospective cohort study with a 12-month follow-up period of 297 patients with asthma. Psychological symptoms, lung function, asthma control test, and Asthma Quality of Life Questionnaire at baseline were assessed. Asthma outcomes including exacerbations, unplanned visits, emergency visits, hospital admissions, intensive care unit admissions, and length of hospital stays were monitored monthly. The time to the first asthma outcomes was analyzed. Furthermore, the association between psychological symptoms and future risk of asthma outcomes was calculated as adjusted relative risk (RR) using logistic regression models.
The asthma patients were assigned to one of three groups: neither anxiety nor depression symptoms (NAD, n = 102), either anxiety or depression symptoms (A/D, n = 68), or anxiety and depression symptoms (AD, n = 120). Logistic regression models indicated that asthma patients in the AD group, but not the A/D group, had an increased adjusted RR for unplanned visits and emergency visits (RR = 2.33, 95% confidence interval (CI) = [1.50, 3.61]; and RR = 3.13, 95% CI = [1.90, 5.17], respectively). The time to the first asthma outcomes including exacerbations, unplanned visits, and emergency visits was shorter in patients with psychological symptoms than those without (all p < .001).
Current psychological symptoms, especially anxiety combined with depression, independently predict the future risk of asthma outcomes. Ting Zhou and Lan Wang contributed equally to this study.
哮喘患者更容易出现心理症状，但心理症状是否与哮喘预后的未来风险相关尚不确定。
研究当前心理症状与哮喘预后未来风险之间的关系。
我们对297例哮喘患者进行了为期12个月的前瞻性队列研究。评估了基线时的心理症状、肺功能、哮喘控制测试和哮喘生活质量问卷。每月监测哮喘预后，包括病情加重、非计划就诊、急诊就诊、住院、重症监护病房住院和住院时间。分析首次出现哮喘预后的时间。此外，使用逻辑回归模型计算心理症状与哮喘预后未来风险之间的关联，以调整相对风险（RR）表示。
哮喘患者被分为三组之一：既无焦虑症状也无抑郁症状（NAD，n = 102）、有焦虑或抑郁症状之一（A/D，n = 68）或有焦虑和抑郁症状（AD，n = 120）。逻辑回归模型表明，AD组而非A/D组的哮喘患者非计划就诊和急诊就诊的调整后RR增加（RR分别为2.33，95%置信区间（CI）= [1.50, 3.61]；RR = 3.13，95%CI = [1.90, 5.17]）。有心理症状的患者首次出现哮喘预后（包括病情加重、非计划就诊和急诊就诊）的时间比没有心理症状的患者短（所有p <.001）。
当前的心理症状，尤其是焦虑合并抑郁，可独立预测哮喘预后的未来风险。周婷和王兰对本研究贡献相同。
