慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停患者的焦虑和抑郁：重叠综合征。
Anxiety and depression in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome.
机构信息
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Biomedical Engineering School, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China.
出版信息
Sleep Breath. 2022 Dec;26(4):1603-1611. doi: 10.1007/s11325-021-02500-2. Epub 2021 Nov 16.
PURPOSE
Psychological symptoms are increasingly being noted in patients with chronic diseases. Currently, little evidence is available on the mental health of patients with overlap syndrome (OVS, chronic obstructive pulmonary disease plus obstructive sleep apnea). This study aimed to describe the prevalence and identify influencing factors of anxiety and depression in patients with OVS.
METHODS
We recruited patients admitted for chronic obstructive pulmonary disease (COPD) from July 2018 to July 2019 who also underwent polysomnography tests to assess obstructive sleep apnea (OSA). COPD patients who had an apnea-hypopnea index (AHI) ≥ 5/h were defined as OVS. COPD patients who had an AHI < 5/h were identified as pure COPD. Questionnaires were administered to evaluate depression and anxiety in all subjects. We compared the differences in scores between patients with OVS and pure COPD.
RESULTS
Two hundred and fifty-two patients were included, 180 (71%) patients had OVS, while only 72 patients had pure COPD. In the OVS group, 54% of the patients had depression, and 77% of the patients had anxiety. We found that patients with OVS had higher anxiety (8.00 (4.00, 10.00) vs. 6.00 (3.00, 9.00), p = 0.018) and depression (8.00 (4.00, 10.00) vs. 5.50 (2.25, 10.00), p = 0.022) scores than patients with pure COPD. A higher proportion of patients with hypertension (41% vs. 21%) and coronary heart disease (14% vs. 4%) were found in the OVS group. Chest pain, COPD Assessment Test (CAT) score, and OVS were independent risk factors for depression (P<0.05). A positive correlation was shown between anxiety and depression (r=0.638, p < 0.001).
CONCLUSIONS
Anxiety and depression were more severe in patients with OVS than in patients with pure COPD. More attention should be paid to the mental health of OVS patients.
TRIAL REGISTRATION
ClinicalTrials.gov; URL: www.
CLINICALTRIALS
gov . NO.: NCT03182309. Registered on June 9, 2017; https://clinicaltrials.gov/ct2/show/NCT03182309?term=NCT+03182309&draw=2&rank=1.
目的
越来越多的慢性疾病患者出现心理症状。目前，关于重叠综合征（OVS，慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停）患者心理健康的证据很少。本研究旨在描述 OVS 患者焦虑和抑郁的患病率，并确定其影响因素。
方法
我们招募了 2018 年 7 月至 2019 年 7 月因慢性阻塞性肺疾病（COPD）住院且同时接受多导睡眠图检查以评估阻塞性睡眠呼吸暂停（OSA）的患者。COPD 患者的呼吸暂停低通气指数（AHI）≥5/h 被定义为 OVS。AHI<5/h 的 COPD 患者被确定为单纯 COPD。所有受试者均接受抑郁和焦虑问卷评估。我们比较了 OVS 组和单纯 COPD 组患者的评分差异。
结果
共纳入 252 例患者，180 例（71%）患者患有 OVS，72 例（29%）患者患有单纯 COPD。在 OVS 组中，54%的患者患有抑郁，77%的患者患有焦虑。我们发现 OVS 患者的焦虑评分更高（8.00（4.00，10.00）vs. 6.00（3.00，9.00），p=0.018）和抑郁评分更高（8.00（4.00，10.00）vs. 5.50（2.25，10.00），p=0.022）。与单纯 COPD 组相比，高血压（41% vs. 21%）和冠心病（14% vs. 4%）患者比例更高。胸痛、COPD 评估测试（CAT）评分和 OVS 是抑郁的独立危险因素（P<0.05）。焦虑和抑郁呈正相关（r=0.638，p<0.001）。
结论
与单纯 COPD 患者相比，OVS 患者的焦虑和抑郁更为严重。应更加关注 OVS 患者的心理健康。
试验注册
ClinicalTrials.gov；网址：www.clinicaltrials.gov。注册号：NCT03182309。注册日期：2017 年 6 月 9 日；https://clinicaltrials.gov/ct2/show/NCT03182309?term=NCT+03182309&draw=2&rank=1。
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