慢阻肺合并高血压病患者特点及焦虑发生危险因素的调查
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摘要
目的研究慢性阻塞性肺疾病(COPD,慢阻肺)伴高血压病患者的特点及焦虑情绪发生的危险因素。方法选取COPD患者196例,其中COPD伴高血压病组104例,COPD组92例,应用医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)评估两组患者焦虑情况,并将COPD伴高血压病患者分为焦虑组和非焦虑组,采集患者一般资料,包括性别、年龄、文化程度、BMI、吸烟史、COPD病程、急性加重次数、m MRC评分、肺功能分级、高血压分级。结果 COPD伴高血压病组和COPD组在性别、年龄等一般情况上的差异无统计学意义(P>0.05),而在m MRC评分、肺功能分级方面存在统计学差异(P<0.05);COPD伴高血压病患者发生焦虑的比例高于COPD患者(P<0.05);焦虑组与非焦虑组在性别、急性加重次数、m MRC评分、肺功能分级、高血压分级等方面存在差异(P<0.05)。结论 COPD患者高血压病的发生与呼吸困难程度、肺功能有着密切关系,同时发现COPD伴高血压病患者发生焦虑的比例更高,女性、急性加重次数增多、呼吸功能障碍、血压水平升高,是这类患者发生焦虑的危险因素。
Objective To study the characteristics of COPD patients complicated with hypertension and the risk factors of anxiety in these patients.Methods 196 patients with COPD were enrolled,including 104 patients in the COPD complicated with hypertension group and 92 cases in the COPD group.All the patients were measured with Hospital Anxiety and Depression Scale( HADS).The 104 COPD patients with hypertension were divided into the anxiety group and the non-anxiety group,and then their general information was collected,including gender,age,educational status,BMI,smoking history,course of disease,the number of acute exacerbation,m MRC,pulmonary function,and hypertension grade.Results There was not statistical difference in general information like gender,age and so on( P > 0.05),but there were obvious differences in m MRC and pulmonary function between the first two group( P < 0.05).The proportion of anxiety was high in COPD patients complicated with hypertension( P < 0.05).There were differences in gender,acute exacerbation,m MRC,pulmonary function and hypertension grade between the anxiety and non-anxiety groups( P < 0.05).Conclusion COPD patients are easily to develop hypertension,which is closely related to m MRC and pulmonary function.It is also found that COPD patients complicated with hypertension are more likely to show anxiety.Female,the increasing number of acute exacerbations,the destruction of respiratory function and the elevation of blood pressure are risk factors for anxiety in these patients.
Objective To study the characteristics of COPD patients complicated with hypertension and the risk factors of anxiety in these patients.Methods 196 patients with COPD were enrolled,including 104 patients in the COPD complicated with hypertension group and 92 cases in the COPD group.All the patients were measured with Hospital Anxiety and Depression Scale( HADS).The 104 COPD patients with hypertension were divided into the anxiety group and the non-anxiety group,and then their general information was collected,including gender,age,educational status,BMI,smoking history,course of disease,the number of acute exacerbation,m MRC,pulmonary function,and hypertension grade.Results There was not statistical difference in general information like gender,age and so on( P > 0.05),but there were obvious differences in m MRC and pulmonary function between the first two group( P < 0.05).The proportion of anxiety was high in COPD patients complicated with hypertension( P < 0.05).There were differences in gender,acute exacerbation,m MRC,pulmonary function and hypertension grade between the anxiety and non-anxiety groups( P < 0.05).Conclusion COPD patients are easily to develop hypertension,which is closely related to m MRC and pulmonary function.It is also found that COPD patients complicated with hypertension are more likely to show anxiety.Female,the increasing number of acute exacerbations,the destruction of respiratory function and the elevation of blood pressure are risk factors for anxiety in these patients.
引文
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[12]PAN Y,CAI W,CHENG Q,et al.Association between anxiety and hypertension:A systematic review and meta-analysis of epidemiological studies[J].Neuropsychiatr Dis Treat,2015,11(4):1121-1130.
[13]LEE H,YOON J Y,KIM I,et al.The effects of personal resources and coping strategies on depression and anxiety in patients with chronic obstructive pulmonary disease[J].Heart Lung,2013,42(6):473-479.
[14]李向荣.慢性阻塞性肺疾病患者焦虑抑郁症状与BODE指数的相关性[J].当代医学,2015,21(17):26-27.
[15]韦铁民,曾春来,陈礼平,等.高血压合并焦虑抑郁[J].中华高血压杂志,2003,11(6):567-569.
[16]刘瑞平.慢性阻塞性肺疾病中焦虑抑郁的情况[D].太原:山西医科大学,2016.
[2]SARAIVA C,ABREU T,NEVES D,et al.Mortality Predictive Factors in Subjects With COPD After a Pulmonary Rehabilitation Program:A 3-Year Study[J].Respir Care,2016,61(9):1179-1185.
[3]IMAIZUMI Y,EGUCHI K,KARIO K.Lung Disease and Hypertension[J].Pulse(Basel),2014,2(1-4):103-112.
[4]王蕾,杨汀,王辰.2017年版慢性阻塞性肺疾病诊断、处理和预防全球策略解读[J].中国临床医生杂志,2017,45(1):104-108.
[5]MANCIA G,FAGARD R,NARKIEWICZ K,et al.2013 ESH/ESC Guidelines for the management of arterial hypertension:The Task Force for the management of arterial hypertension of the European Society of Hypertension(ESH)and of the European Society of Cardiology(ESC)[J].J Hypertens,2013,31(7):1281-1357.
[6]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版)[Z].北京:中国心理卫生杂志社,1999:194-195.
[7]KIM S H,PARK J H,LEE J K,et al.Chronic obstructive pulmonary disease is independently associated with hypertension in men:A survey design analysis using nationwide survey data[J].Medicine(Baltimore),2017,96(19):e6826-e6832.
[8]王浩彦,徐秋芬,杨霁,等.慢性阻塞性肺疾病并发肺外系统疾病调查[J].医学研究杂志,2011,40(4):47-49.
[9]MACLAY J D,MACNEE W.Cardiovascular disease in COPD:Mechanisms[J].Chest,2013,143(3):798-807.
[10]GOTTSCHALK F,MUELLER S,GROTH A,et al.Classification of Chronic Obstructive Pulmonary Disease(COPD)Severity According to the Global Initiative for Chronic Obstructive Lung Disease(Gold):Variations in the Defintion of Gold Groups and Their Impact on Stage Assignment[J].Value Health,2017,20(9):A772-A779.
[11]VAN GESTEL A J,KOHLER M,CLARENBACH C F.Sympathetic overactivity and cardiovascular disease in patients with chronic obstructive pulmonarypulmonary disease(COPD)[J].Discov Med,2012,14(79):359-368.
[12]PAN Y,CAI W,CHENG Q,et al.Association between anxiety and hypertension:A systematic review and meta-analysis of epidemiological studies[J].Neuropsychiatr Dis Treat,2015,11(4):1121-1130.
[13]LEE H,YOON J Y,KIM I,et al.The effects of personal resources and coping strategies on depression and anxiety in patients with chronic obstructive pulmonary disease[J].Heart Lung,2013,42(6):473-479.
[14]李向荣.慢性阻塞性肺疾病患者焦虑抑郁症状与BODE指数的相关性[J].当代医学,2015,21(17):26-27.
[15]韦铁民,曾春来,陈礼平,等.高血压合并焦虑抑郁[J].中华高血压杂志,2003,11(6):567-569.
[16]刘瑞平.慢性阻塞性肺疾病中焦虑抑郁的情况[D].太原:山西医科大学,2016.