内科

目的了解我国中老年慢性肺部疾病（CLD）患者健康生活方式与抑郁症状的现状，并探讨健康生活方式与抑郁症状的关联。方法利用中国健康与养老追踪调查（CHARLS）2020年数据，筛选年龄≥45岁且自我报告经医生诊断为CLD的患者作为研究对象。以吸烟、饮酒、体育锻炼、睡眠时长、社交活动5项指标构建健康生活方式评分，以流行病学研究中心抑郁量表（CES-D）简化版评估抑郁症状现状。采用二元logistic回归模型分析健康生活方式与中老年CLD患者抑郁症状的关联。结果本研究共纳入798名中老年CLD患者，其中遵循健康生活方式者占26.82%（214/798），有抑郁症状者占69.80%（557/798）。单因素分析结果显示，无抑郁症状者与有抑郁症状者在性别、学历、有无配偶、是否上网、是否合并其他慢性病、过去1个月内是否看过门诊、过去1年内是否住过院、自评健康状况、是否遵循健康生活方式方面的差异均有统计学意义（均P<0.05）。二元logistic回归分析结果显示，在控制各项潜在混杂因素，遵循健康生活方式与中老年CLD患者抑郁症状风险较低相关（OR=0.698，95%CI：0.521～0.935）。结论我国中老年CLD患者健康生活方式遵循率低，抑郁症状检出率高；健康生活方式与其抑郁症状风险较低存在关联。

Objective To investigate the current status of healthy lifestyle and depressive symptoms among middle-aged and elderly patients with chronic lung diseases (CLD) in China, and to explore the correlation between healthy lifestyle and depressive symptoms. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS) 2020 were utilized. Participants aged ≥45 years with a self-reported physician-diagnosed CLD were included. A healthy lifestyle score was constructed based on 5 indicators, namely smoking, alcohol consumption, physical exercise, sleep duration, and social activities. The simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the current status of depressive symptoms. A binary logistic regression model was adopted to analyze the correlation between healthy lifestyle and depressive symptoms in middle-aged and elderly CLD patients. Results A total of 798 middle-aged and elderly CLD patients were enrolled in this study. Among them, 26.82% (214/798) adhered to a healthy lifestyle, and 69.80% (557/798) had depressive symptoms. Univariate analysis results showed that there were statistically significant differences between patients without depressive symptoms and those with depressive symptoms in terms of gender, educational level, marital status (having a spouse or not), internet usage, comorbidity with other chronic diseases, outpatient visits in the past month, hospitalization experience in the past year, self-rated health status, and adherence to a healthy lifestyle (all P<0.05). The results of binary logistic regression analysis indicated that after controlling for various potential confounding factors, adhering to a healthy lifestyle was associated with a lower risk of depressive symptoms in middle-aged and elderly CLD patients (OR=0.698, 95%CI: 0.521-0.935). Conclusion The adherence rate to a healthy lifestyle is low and the detection rate of depressive symptoms is high among middle-aged and elderly CLD patients in China; a healthy lifestyle is correlated with a lower risk of depressive symptoms.