BAO Jinying , FU Xuan , LI Jing , LIANG Xiaoao , ZHAO Xincheng
  • Department of Respiratory and Critical Care Medicine, Lianyungang Municipal Oriental Hospital Affiliated to Kangda College, Nanjing Medical University, Liangyungang, Jiangsu 222042, P.R. China;
ZHAO Xincheng, Email: 540143249@qq.com
Chronic obstructive pulmonary disease; Anxiety / Depression; Risk factors; Inflammatory factors; Risk prediction
10.7507/1671-6205.202407036
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Objective To explore the risk factors and risk prediction model of chronic obstructive pulmonary disease(COPD) with anxiety and depression. Methods From January 2022 to June 2024, 276 patients with COPD in stable stage after treatment in Lianyungang Municipal Oriental Hospital were selected, the Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to screen the questionnaire, 93 COPD patients without anxiety and depression were included in the simple group, 87 COPD patients with anxiety and depression were included in the complication group. The gender, age, height, weight, education level, marital status, place of residence, occupation, economic income, payment method of medical expenses, number of smoking, drinking history, number of hospitalizations in the previous year, course of disease, pulmonary heart disease, type 2 respiratory failure, inhaled glucocorticoids, taking theophylline drugs, taking fluoroquinolones, home oxygen therapy and other factors were compared between the two groups. The independent variable indexes with differences between the two groups were selected for single factor analysis, and the independent variables with multicollinearity were eliminated. Multivariate binomial logistic regression was used to analyze the independent risk factors, and build a risk prediction model and verify it. Results The prevalence of COPD combined with anxiety and depression was 39.5 %; Univariate analysis showed that economic income, medical expenses, smoking, number of hospitalizations, course of disease, FEV1 % pred, pulmonary heart disease, type 2 respiratory failure, inhaled corticosteroids, CAT score, CRP, IL-6, TNF-α were the influencing factors of COPD combined with anxiety and depression(P<0.05); Multivariate logistic regression analysis showed that the course of disease and pulmonary heart disease were independent risk factors for COPD combined with anxiety and depression(OR=1.110, 3.065, P=0.014, 0.002), elevated FEV1 % pred is an independent protective factor for COPD with anxiety and depression(OR=0.930, P<0.001); The regression equation of the risk prediction model of COPD combined with anxiety and depression was constructed: Logit(P)=ln[P/(1–P)]=1.695+0.104×disease process+1.120×pulmonary heart disease–0.072×FEV1%pred; The Hosmer-Lemeshow test showed that χ2 = 5.655, P = 0.686, indicating that the model had good goodness of fit. Conclusions The prevalence of COPD with anxiety and depression in this region is at a high level, long course of disease and pulmonary heart disease are independent risk factors for COPD combined with anxiety and depression, elevated FEV1%pred is an independent protective factor for COPD with anxiety and depression. Early active treatment of COPD(equivalent to shortening the course of disease), increasing FEV1 % pred, and preventing the progression of pulmonary heart disease can reduce the risk of COPD combined with anxiety and depression.

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