焦虑、抑郁与哮喘控制密切相关
2009/11/16
背景：本试验研究患者特征（包括焦虑与抑郁）与哮喘控制水平（通过哮喘控制检测[ACT]、自我管理有效性问卷评价）之间的关系。
方法：该研究是一项在意大利3个医院哮喘门诊患者中进行的横断面研究。共获得315例患者的人口统计学信息、肺活量检测数据、焦虑和抑郁评分以及哮喘控制水平。
结果：哮喘控制较差的患者在女性、年长、肺功能较差、肥胖及焦虑和/或抑郁的患者中更为常见。经ACT评价，发现4个独立因素与哮喘控制较差相关：FEV1<60%（OR: 6.52）、焦虑（OR: 3.76）、年龄≥65岁（OR: 2.69）和抑郁（OR: 2.45）。焦虑和抑郁与卫生资源利用程度高相关。最后，本研究显示ACT和多维GINA法在评价哮喘控制上具有高度一致性，两者在239名患者（81%的研究对象）中检测结果一致。
结论：焦虑和抑郁与哮喘控制较差显著相关。更好了解该相关性具有重要的临床意义，特别是对于那些哮喘控制较差的患者，需对其出现的焦虑和抑郁进行研究。
（林江涛 审校）
Respir Med. 2009 Sep 2. [Epub ahead of print]
Close correlation between anxiety, depression, and asthma control.
Di Marco F, Verga M, Santus P, Giovannelli F, Busatto P, Neri M, Girbino G, Bonini S, Centanni S.
Clinica di Malattie dell’Apparato Respiratorio, Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.
BACKGROUND: We investigated the correlation between patients’ characteristics, including anxiety and depression, and the level of asthma control evaluated by asthma control test (ACT), a self-administered validated questionnaire.
METHODS: This is a cross-sectional study on asthmatic outpatients of three Italian hospitals. Demographic data, spirometry, anxiety and depression scores as well as the level of asthma control from 315 patients were collected.
RESULTS: Patients with poorly controlled asthma were more frequently women, older, with a worse pulmonary function, obese, more anxious and/or more depressed. Four different independent factors associated with poor asthma control evaluated by ACT have been found: FEV(1)<60% (odds ratio, OR: 6.52), anxiety (OR: 3.76), age >/=65years (OR: 2.69), and depression (OR: 2.45). The presence of anxiety and depression was associated with a higher healthcare utilization. Finally, we found a high level of agreement between ACT and multidimensional GINA approach in evaluating asthma control, with a concordance in 239 patients (81% of the population).
CONCLUSION: There is a close correlation between anxiety and depression, and a poor asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.
Di Marco F, et al. Respir Med. 2009 Sep 2. [Epub ahead of print]
方法：该研究是一项在意大利3个医院哮喘门诊患者中进行的横断面研究。共获得315例患者的人口统计学信息、肺活量检测数据、焦虑和抑郁评分以及哮喘控制水平。
结果：哮喘控制较差的患者在女性、年长、肺功能较差、肥胖及焦虑和/或抑郁的患者中更为常见。经ACT评价，发现4个独立因素与哮喘控制较差相关：FEV1<60%（OR: 6.52）、焦虑（OR: 3.76）、年龄≥65岁（OR: 2.69）和抑郁（OR: 2.45）。焦虑和抑郁与卫生资源利用程度高相关。最后，本研究显示ACT和多维GINA法在评价哮喘控制上具有高度一致性，两者在239名患者（81%的研究对象）中检测结果一致。
结论：焦虑和抑郁与哮喘控制较差显著相关。更好了解该相关性具有重要的临床意义，特别是对于那些哮喘控制较差的患者，需对其出现的焦虑和抑郁进行研究。
（林江涛 审校）
Respir Med. 2009 Sep 2. [Epub ahead of print]
Close correlation between anxiety, depression, and asthma control.
Di Marco F, Verga M, Santus P, Giovannelli F, Busatto P, Neri M, Girbino G, Bonini S, Centanni S.
Clinica di Malattie dell’Apparato Respiratorio, Ospedale San Paolo, Università degli Studi di Milano, Milano, Italy.
BACKGROUND: We investigated the correlation between patients’ characteristics, including anxiety and depression, and the level of asthma control evaluated by asthma control test (ACT), a self-administered validated questionnaire.
METHODS: This is a cross-sectional study on asthmatic outpatients of three Italian hospitals. Demographic data, spirometry, anxiety and depression scores as well as the level of asthma control from 315 patients were collected.
RESULTS: Patients with poorly controlled asthma were more frequently women, older, with a worse pulmonary function, obese, more anxious and/or more depressed. Four different independent factors associated with poor asthma control evaluated by ACT have been found: FEV(1)<60% (odds ratio, OR: 6.52), anxiety (OR: 3.76), age >/=65years (OR: 2.69), and depression (OR: 2.45). The presence of anxiety and depression was associated with a higher healthcare utilization. Finally, we found a high level of agreement between ACT and multidimensional GINA approach in evaluating asthma control, with a concordance in 239 patients (81% of the population).
CONCLUSION: There is a close correlation between anxiety and depression, and a poor asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.
Di Marco F, et al. Respir Med. 2009 Sep 2. [Epub ahead of print]
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