Uzer Fatih, Cilli Aykut, Hanta Ismail, Coskun Funda, Sevinc Can, Ursavaş Ahmet, Leblebici Asim, Yilmaz Gozde, Yazici Celik Gamze, Kamel Ibrahim
Department of Respiratory Medicine, Akdeniz University School of Medicine, Antalya, Turkey.
Department of Respiratory Medicine, Cukurova University School of Medicine, Adana, Turkey.
Sarcoidosis Vasc Diffuse Lung Dis. 2024 Sep 24;41(3):e2024043. doi: 10.36141/svdld.v41i3.15805.
This study aimed to examine how dyspnea, cough, sleep disruption, anxiety, depression, and physiological factors affect the quality of life in newly diagnosed, untreated IPF patients.
This study is a multicenter observational study. Patients not receiving antifibrotic treatment were included. To assess patients' quality of life, Leicester Cough Questionnaire (LCQ), St. George's Respiratory Questionnaire (SGRQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Borg Dyspnea Index (BDI), Modified Medical Research Council Dyspnea Scale (MMRC) score, Composite Physiological Index (CPI), Gender Age and physiology (GAP) score, and Pittsburgh Sleep Quality Index (PSQI) were administered.
Among 88 patients (mean age: 67.6±8.5 years), 81.9% were diagnosed with IPF through HRCT, 14.8% through surgery, and 3.4% via cryobiopsy. The average disease duration was 2.2±2.9 years. Over 50% experienced moderate to severe depression, and 40% had moderate to severe anxiety. In the IPF group, 13.6% had possible usual interstitial pneumonia (UIP), and 81.8% had definite UIP pattern. No significant differences were found between UIP groups in various scores. Anxiety and depression correlated negatively with respiratory function and positively with MMRC score and BDI. Sleep quality scores had similar correlations. Patients with good sleep quality had better respiratory parameters (p=0.013), lower MMRC (p=0.004), BDI (p=0.026), and CPI (p=0.047). -Conclusion: A notable number of IPF patients in follow-up show symptoms of anxiety and depression. Moreover, declining respiratory function not only diminishes sleep quality but also elevates dyspnea scores.
本研究旨在探讨呼吸困难、咳嗽、睡眠障碍、焦虑、抑郁和生理因素如何影响新诊断的、未经治疗的特发性肺纤维化（IPF）患者的生活质量。
本研究为多中心观察性研究。纳入未接受抗纤维化治疗的患者。为评估患者的生活质量，使用了莱斯特咳嗽问卷（LCQ）、圣乔治呼吸问卷（SGRQ）、简明健康调查问卷（SF - 36）、医院焦虑抑郁量表（HADS）、博格呼吸困难指数（BDI）、改良医学研究委员会呼吸困难量表（MMRC）评分、综合生理指数（CPI）、性别年龄与生理（GAP）评分以及匹兹堡睡眠质量指数（PSQI）。
在88例患者（平均年龄：67.6±8.5岁）中，81.9%通过高分辨率计算机断层扫描（HRCT）诊断为IPF，14.8%通过手术诊断，3.4%通过冷冻活检诊断。平均病程为2.2±2.9年。超过50%的患者经历中度至重度抑郁，40%有中度至重度焦虑。在IPF组中，13.6%可能患有普通型间质性肺炎（UIP），81.8%有明确的UIP型。各UIP组在各项评分上未发现显著差异。焦虑和抑郁与呼吸功能呈负相关，与MMRC评分和BDI呈正相关。睡眠质量评分也有类似的相关性。睡眠质量良好的患者呼吸参数更好（p = 0.013），MMRC更低（p = 0.004），BDI更低（p = 0.026），CPI更低（p = 0.047）。
相当数量的随访IPF患者表现出焦虑和抑郁症状。此外，呼吸功能下降不仅会降低睡眠质量，还会提高呼吸困难评分。
