焦虑和抑郁与慢性阻塞性肺疾病（COPD）患者的呼吸困难及临床控制有关，但与胸腹力学无关。
Anxiety and depression are related to dyspnea and clinical control but not with thoracoabdominal mechanics in patients with COPD.
作者信息
Borges-Santos Erickson, Wada Juliano Takashi, da Silva Cibele Marques, Silva Ronaldo A, Stelmach Rafael, Carvalho Celso R, Lunardi Adriana C
机构信息
Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Department of Pneumology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
出版信息
Respir Physiol Neurobiol. 2015 May;210:1-6. doi: 10.1016/j.resp.2015.01.011. Epub 2015 Jan 22.
OBJECTIVE
To investigate the relationship between the presence of symptoms of anxiety or depression with breathing pattern and thoracoabdominal mechanics at rest and during exercise in COPD.
METHODS
Cross-sectional study enrolled 54 patients with COPD ranked according to Hospital Anxiety and Depression Scale (HAD) score and compared to dyspnea, clinical control, hypercapnia, breathing pattern and thoracoabdominal mechanics at rest and during exercise.
RESULTS
Seventeen patients with COPD had no symptoms, 12 had anxiety symptoms, 13 had depressive symptoms and 12 had both symptoms. COPD with depressive symptoms presented greater degree of dyspnea (p<0.01). Poor clinical control was observed in COPD with anxious and/or depressive symptoms (p<0.05). Breathing pattern and thoracoabdominal mechanics were similar among all groups at rest and during exercise.
CONCLUSIONS
COPD with symptoms of depression report more dyspnea. Anxiety and depression are associated with poor clinical control without impact on breathing pattern and thoracoabdominal mechanics in COPD.
目的
探讨慢性阻塞性肺疾病（COPD）患者静息及运动时焦虑或抑郁症状的存在与呼吸模式及胸腹力学之间的关系。
方法
横断面研究纳入了54例根据医院焦虑抑郁量表（HAD）评分进行排序的COPD患者，并将其与静息及运动时的呼吸困难、临床控制情况、高碳酸血症、呼吸模式及胸腹力学进行比较。
结果
17例COPD患者无症状，12例有焦虑症状，13例有抑郁症状，12例同时有两种症状。有抑郁症状的COPD患者呼吸困难程度更高（p<0.01）。有焦虑和/或抑郁症状的COPD患者临床控制情况较差（p<0.05）。所有组在静息及运动时的呼吸模式和胸腹力学相似。
结论
有抑郁症状的COPD患者报告的呼吸困难更多。焦虑和抑郁与临床控制不佳有关，但对COPD患者的呼吸模式和胸腹力学无影响。
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