Effects Of Noninvasive Positive Pressure Ventilation On Anxiety/depression And Expression Of Related Inflammatory Factors,nerve Factors In Patients With COPD

Objective:The purpose of this study was to evaluate the anxiety/depression status in severe to extremely severe chronic obstructive pulmonary disease（COPD）patients,observe serum inflammatory factors interleukin-1（IL-1）and interleukin-2（IL-2）,nerve factors vasoactive intestinal peptide（VIP）,somatostatin（SS）,myelin basic protein（MBP）content,and to explore the correlation between the content and anxiety/depression in severe to extremely severe COPD patients.To observe the effects of noninvasive positive pressure ventilation（NPPV）treatment on anxiety/depression in patients with severe to extremely severe COPD.Methods:Eligible 130 severe to extremely severe COPD patients were collected from the Affiliated Hospital of Hangzhou Normal University during September 2018to November 2020,all patients were in stable state.After the Self-rating anxiety scale（SAS）and self-rating depression scale（SDS）were used,the patients were divided into control group（n=50）,treatment group:anxiety group（n=44）and depression group（n=36）.All patients were examined for pulmonary function and the test of bronchodilation;arterial blood was used for arterial blood gas analysis;the ability of daily living scale（ADLS）was assessed the ability to perform daily activities.At the same time,relevant clinical datas were collected and enzyme linked immunosorbent assay（ELISA）test to detect the levels of serum IL-1,IL-2,VIP,SS and MBP.After NPPV treatment,the patients in anxiety/depression group were evaluated at baseline.Results:（1）Of the 130 patients enrolled,there were 44 COPD patients combined with anxiety（33.8%）,36 COPD patients combined with depression（27.7%）,the rest of patients were neither depressed nor anxious（38.5%）.（2）The total course of disease,the number of acute exacerbations in the previous year,the total medical expenses in the previous year,the smoking index,Pa O₂,Pa CO₂,FEV₁/FVC and FEV₁pred%were related to the occurrence of anxiety/depression in severe to extremely severe COPD patients（P<0.05）;but had nothing to do with sex,age,BMI,years of schooling and the score of ADLS.（3）Comparison of serological indexes:The levels of serum IL-1,IL-2,VIP,SS,and MBP were significantly increased in the anxiety/depression group compared with the control group（P<0.05）.（4）Pearson correlation test:SAS score showed positive correlation with serum levels of IL-1,IL-2,VIP,SS and MBP（r=0.373,r=0.510,r=0.323,r=0.527,r=0.702,P<0.05）;SDS score showed positive correlation with serum levels of IL-1,IL-2,VIP,SS and MBP（r=0.478,r=0.359,r=0.550,r=0.309,r=0.183,P<0.05）.FEV₁/FVC showed negative correlation with serum levels of IL-1,IL-2,VIP,SS and MBP（r=-0.554,r=-0.565,r=-0.566,r=-0.526,r=-0.612,P<0.05）;FEV₁pred%showed negative correlation with serum levels of IL-1,IL-2,VIP,SS and MBP（r=-0.399,r=-0.428,r=-0.426,r=-0.430,r=-0.541,P<0.05）.Pa O₂showed negative correlation with serum levels of IL-1,IL-2,VIP,SS,MBP（r=-0.577,r=-0.599,r=-0.602,r=-0.606,r=-0.651,P<0.05）;Pa CO₂showed positive correlation with serum levels of IL-1,IL-2,VIP,SS,MBP（r=0.482,r=0.494,r=0.509,r=0.500,r=0.545,P<0.05）.（5）After NPPV treatment,SAS score of the anxiety group and SDS score of the depression group decreased,while the levels of serum inflammatory factors IL-1,IL-2and nerve factors VIP,SS,MBP decreased,and the difference was statistically significant compared with before（P<0.05）.Conclusion:Anxiety/depression in patients with severe to extremely severe COPD may be related to the levels of serum IL-1,IL-2,VIP,SS and MBP.NPPV treatment can improve the anxiety/depression of severe to extremely severe COPD patients,attenuate inflammatory response,and reduce the levels of VIP,SS and MBP.