Katare Srikanth, Harsha Ajit
Respiratory Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND.
Cureus. 2022 Mar 1;14(3):e22742. doi: 10.7759/cureus.22742. eCollection 2022 Mar.
Introduction Tuberculosis-associated obstructive pulmonary disease (TOPD), anxiety, and depression are significant public health problems worldwide and their prevalence is common. These diseases interfere with physical, psychosocial, and economic well-being, resulting in unemployment, prolonged hospitalization, abstinence from working, and isolation. Subjects and methods This is a single-center, cross-sectional cohort, observational study conducted in a tertiary care hospital over six years to understand spirometry, laboratory profiles, as well as the impact on overall health, daily life, and perceived well-being in patients with TOPD. Result The sample size of the study was 73 patients. A total of 43 (58.5%) patients had depression with an average St. George's Respiratory Questionnaire for chronic obstructive pulmonary disease (SGRQ-C) score of 67.5, and 16 (21.9%) patients had anxiety with an average SGRQ-C score of 78.9. In the patients who scored higher on the Hamilton Depression Rating Scale (HAM-D), there was a significant correlation between Hamilton Anxiety Rating Scale (HAM-A) and HAM-D scores, as well as C-reactive protein (CRP) levels and WBC counts. In 16 (21.9%) of the patients with moderate to severe anxiety, there was a statistically significant negative correlation between higher HAM-A scores and lower WBC counts. Anxiety, depression, CRP level, WBC count, and serum fibrinogen did not show a significant correlation with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups-based assessment of TOPD severity. A high serum fibrinogen level did not correlate with a high HAM-D score, nor did a high CRP level correlate with a high HAM-A score. Conclusion Psychiatric comorbidities like depression are associated with increased inflammation in chronic diseases like TOPD, but no definitive biomarker has been identified and further studies are required to identify suitable biomarkers.
引言 结核病相关阻塞性肺疾病（TOPD）、焦虑和抑郁是全球重大的公共卫生问题，且普遍存在。这些疾病会干扰身体、心理社会和经济福祉，导致失业、长期住院、无法工作和孤立。
对象与方法 这是一项在一家三级医疗中心进行的单中心、横断面队列观察性研究，为期六年，旨在了解TOPD患者的肺功能测定、实验室检查结果，以及对其整体健康、日常生活和幸福感的影响。
结果 该研究的样本量为73例患者。共有43例（58.5%）患者患有抑郁症，慢性阻塞性肺疾病圣乔治呼吸问卷（SGRQ-C）平均得分为67.5分；16例（21.9%）患者患有焦虑症，SGRQ-C平均得分为78.9分。在汉密尔顿抑郁量表（HAM-D）得分较高的患者中，汉密尔顿焦虑量表（HAM-A）得分与HAM-D得分以及C反应蛋白（CRP）水平与白细胞计数之间存在显著相关性。在16例（21.9%）中重度焦虑患者中，较高的HAM-A得分与较低的白细胞计数之间存在统计学显著负相关。焦虑、抑郁、CRP水平、白细胞计数和血清纤维蛋白原与基于慢性阻塞性肺疾病全球倡议（GOLD）分组的TOPD严重程度评估无显著相关性。高血清纤维蛋白原水平与高HAM-D得分无关，高CRP水平与高HAM-A得分也无关。
结论 抑郁症等精神共病与TOPD等慢性疾病中炎症增加有关，但尚未确定明确的生物标志物，需要进一步研究以确定合适的生物标志物。
