Velichko Valentyna I, Bazhora Yana I, Danilchuk Galyna O, Kolotvina Larysa I
Odessa National Medical University, Odessa, Ukraine.
Wiad Lek. 2019;72(4):657-663.
Introduction: The worldwide pandemic of bronchial asthma (BA) is creating severe challenges for health care specialists. Asthma patients feature a number of psycho-emotional and cognitive impairments, mark the reduction of quality of life which limits response to therapy. The aim: to investigate psycho-emotional features, state of cognitive function and assess bronchial asthma patients quality of life.
Materials and methods: 142 patients (61 men and 81 women) with bronchial asthma aged 19 - 57 y.o. were examined. The main group consisted of 78 patients with an uncontrolled course of asthma (UCBA). 64 patients with controlled asthma (CBA) were included in the comparison group. The subjective assessments of quality of life by questionnaire SF-36, assessment of asthma-dependent quality of life (AQLQ) was made. The patients' emotional and psychological profile was assessed using the following tests and scales: MMSE, Montreal Scale for Assessing Cognitive Function, Hospital Alert and Depression (HADS) scale with a qualitative and quantitative assessment of the results.
Results: According to the results obtained, the averaged profiles of the patients' quality of life demonstrated the negative effects of asthma, especially its uncontrolled form. There were statistically significant differences in the quality of life in patients with UCBA according to the five criteria of the MOS SF-36 questionnaire as compared to the CBA group ( physical functioning, role-playing, caused by physical condition, general health, social functioning, viability). A comparison of the specific quality of life with the help of the AQLQ questionnaire revealed a significant negative effect of the uncontrolled course of the illness on the patients' quality of life. The correlation analysis of the relationship between the course of asthma and the parameters of a specific life qality showed a close correlation between the level of asthma control and the overall evaluation of specific quality of life (r = 0 , 62; p < 0.001). The results of neuropsychological examinations in UCBA patients showed the presence of light predemention cognitive impairments. Manifestations of anxiety-depressive disorders were found in 44 (56.41%) patients in the main group, while in the comparison group, the symptoms of anxiety and depression were observed in 14 (21.88%) cases. Patients with UCBA noted a higher level of anxiety (11.5 ± 1.2 versus 6.9 ± 1.4, p <0.05), depression (8.3 ± 2.3 versus 5.6 ± 3.9) on the HADS scale compared with patients with CBA.
Conclusion: The psycho-emotional features revealed in UCBA patients can determine the prognosis of the disease and justify the expediency of additional diagnostic and therapeutic psychotherapeutic measures.
引言：支气管哮喘（BA）的全球大流行给医疗保健专家带来了严峻挑战。哮喘患者存在多种心理情绪和认知障碍，这标志着生活质量下降，限制了治疗反应。目的：研究心理情绪特征、认知功能状态并评估支气管哮喘患者的生活质量。
材料与方法：对142例年龄在19 - 57岁的支气管哮喘患者（61例男性和81例女性）进行了检查。主要组由78例哮喘控制不佳（UCBA）的患者组成。64例哮喘控制良好（CBA）的患者被纳入比较组。通过SF - 36问卷对生活质量进行主观评估，对依赖哮喘的生活质量（AQLQ）进行评估。使用以下测试和量表评估患者的情绪和心理状况：简易精神状态检查表（MMSE）、蒙特利尔认知功能评估量表、医院焦虑和抑郁量表（HADS），并对结果进行定性和定量评估。
结果：根据所得结果，患者生活质量的平均状况显示出哮喘的负面影响，尤其是其未控制的形式。与CBA组相比，根据MOS SF - 36问卷的五个标准，UCBA患者的生活质量存在统计学显著差异（身体功能、角色功能、因身体状况导致的角色功能、总体健康、社会功能、活力）。借助AQLQ问卷对特定生活质量进行比较，结果显示疾病未控制的病程对患者生活质量有显著负面影响。哮喘病程与特定生活质量参数之间的相关性分析表明，哮喘控制水平与特定生活质量的总体评估之间存在密切相关性（r = 0.62；p < 0.001）。UCBA患者的神经心理学检查结果显示存在轻度认知功能减退。主要组中44例（56.41%）患者存在焦虑抑郁障碍表现，而在比较组中，14例（21.88%）出现焦虑和抑郁症状。与CBA患者相比，UCBA患者在HADS量表上的焦虑水平更高（11.5 ± 1.2对6.9 ± 1.4，p < 0.05），抑郁水平更高（8.3 ± 2.3对5.6 ± 3.9）。
结论：UCBA患者中揭示的心理情绪特征可决定疾病预后，并证明采取额外的诊断和治疗性心理治疗措施的合理性。
