维生素D 对慢性阻塞性肺疾病合并肺动脉高压 患者焦虑、抑郁及生活质量的影响

Effect of serum vitamin D on anxiety, depression and quality of life in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease

摘要:

目的 探讨血清25- 羟维生素D[25（OH）D] 与慢性阻塞性肺疾病（COPD）合并肺动脉高压（PH） 患者焦虑、抑郁及生活质量的关系。方法 选取2015 年1 月—2018 年3 月海南省人民医院收治的182 例稳 定期COPD 患者，收集患者年龄、性别、吸烟、体重指数（BMI）及第1 秒用力呼气容积占用力肺活量百分 比（FEV1/FVC）等基本情况。采用心脏彩超测肺动脉收缩压（PASP），根据PASP ≥ 40 mmHg 分为COPD 伴PH 组（80 例）和单纯COPD 组（102 例）。采用酶联免疫吸附法检测两组患者25（OH）D 水平；采用 汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）及慢性阻塞性肺疾病评估测试问卷（CAT）分 别评定两组患者焦虑、抑郁及生活质量情况。结果 COPD 伴PH 组25（OH）D、HAMA、HAMD 及CAT 评分高于单纯COPD 组（P <0.05）。25（OH）D 缺乏组HAMA、HAMD 及CAT 评分高于25（OH）D 正 常组（P <0.05）。多元线性回归调整年龄、性别及BMI 等混杂因素后，25（OH）D 对COPD 合并PH 患者 HAMD 及CAT 评分有负向影响（P <0.05）。结论 血清25（OH）D 水平与COPD 合并PH 患者抑郁及生 活质量密切相关。

Abstract:

Objective To investigate the relationship between serum 25- hydroxyvitamin D [25 (OH) D] and anxiety, depression and quality of life in patients with pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD). Methods A total of 182 patients were enrolled in this study. The patients were divided into COPD group (80 cases) and COPD combined with PH group (102 cases ) according to pulmonary artery systolic pressure (PASP) ≥40 mmHg measured by echocardiography. The age, gender, smoking, body mass index (BMI), forced expiratory volume in the first second accounted for the percentage of forced vital capacity (FEV1/FVC) and so on were collected. Serum levels of 25 (OH) D was measured by ELISA. The Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD) and the chronic obstructive pulmonary disease assessment test questionnaire (CAT) were used to evaluate the anxiety, depression and quality of life of the two groups. Results The scores of 25 (OH) D, HAMA, HAMD and CAT in COPD with PH group were higher than those in COPD group (P < 0.05). The scores of HAMA, HAMD and CAT in 25 (OH) D deficiency group were higher than those in 25 (OH) D normal group (P < 0.05). After adjusting for age, sex and BMI by multiple linear regression, 25 (OH) D had a nega tive effect on HAMD and CAT scores in COPD patients with PH (P < 0.05). Conclusions Serum vitamin D was closely related to depression and quality of life in patients with pulmonary hypertension associated with chronic obstructive pulmonary disease.