摘要
目的评估冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入治疗(PCI)后抑郁及焦虑发生状况,并分析其危险因素。方法纳入2017年1月至2018年10月在甘肃省人民医院心内科均经焦虑抑郁评估为无焦虑抑郁状况且成功行PCI术220例冠心病出院后1年的患者。采取抑郁自评量表(SDS)及焦虑自评量表(SAS)收集患者的心理评估结果并经logistic单因素与多因素回归分析危险因素。结果成功随访评估200例患者,平均年龄为(59.4±5.3)岁,抑郁患者60例(30.0%)、焦虑患者76例(38.0%)。logistic多因素回归分析显示,女性(OR 1.438,95%CI 1.224~5.856,P=0.014)、合并基础疾病(OR 2.633,95%CI 1.632~7.493,P=0.013)、有急诊PCI术史(OR 3.724,95%CI 1.594~8.702,P=0.002)及住院费用≥3.0万元(OR 2.143,95%CI 1.074~4.277,P=0.030)是PCI术后抑郁的危险因素;年龄≥60岁(OR 1.579,95%CI 1.212~6.856,P=0.019)、合并基础疾病(OR 3.429,95%CI 1.538~7.642,P=0.003)、既往PCI术(OR 3.617,95%CI 1.532~8.539,P=0.003)、支架数目≥2枚(OR 4.124,95%CI 1.798~9.455,P=0.001)、住院费≥3.0万元(OR 3.315,95%CI 1.427~7.700,P=0.005)是PCI术后焦虑的危险因素。结论经PCI术治疗的冠心病患者有较高的抑郁及焦虑发病率。对于甘肃农村地区的女性、年龄在60岁以上、合并高血压病、糖尿病及高脂血症等基础疾病、有既往PCI术史、有急诊PCI术史、置入支架数目≥2枚及经济负担较重的PCI术后患者应给予更多心理社会支持。
Objective The purpose of this study was to evaluate the incidence of depression and anxiety in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI)and analyze the risk factors.Methods A total of 220 patients with CHD who were assessed as having no anxiety and depression in the Department of Cardiology,Gansu Provincial Hospital,from January 2017 to October 2018 and successfully treated by PCI for 1 year.Self rating Depression Scale(SDS)and Self rating Anxiety Scale(SAS)were used to collect the psychological evaluation results of patients and analyze the risk factors by univariate and multivariate logistic regression.Results All 200 patients were successfully studied,the average age was(59.4±5.3)years old,60 patients with depression(30.0%),76 patients with anxiety(38.0%).Results of multivariate logistic regression analysis show that the female(OR 1.438,95%CI 1.224~5.856,P=0.014),combined with basic diseases(OR 2.633,95%CI 1.632~7.493,P=0.013),emergency PCI(OR 3.724,95%CI 1.594~8.702,P=0.002),hospitalization fee≥30000 yuan(OR 2.143,95%CI 1.074~4.277,P=0.030)were risk factors of depression patients,and≥60 years old(OR 1.579,95%CI 1.212~6.856,P=0.019),combined with hypertension,diabetes and hyperlipidemia of basic diseases(OR 3.429,95%CI 1.538~7.642,P=0.003),previous PCI(OR 3.617,95%CI 1.532~8.539,P=0.003),≥2 pieces stents(OR 4.124,95%CI 1.798~9.455,P=0.001),hospitalization fee≥30000 yuan(OR 3.315,95%CI 1.427~7.700,P=0.005)were risk factors of anxiety patients.Conclusions Patients with CHD treated by PCI have higher prevalence of depression and anxiety.More psychosocial support should be given to those special patients,who are women,over 60 years old,lived in rural areas,with hypertension,diabetes and hyperlipidemia of basic diseases,having history of PCI,emergency PCI,≥2 stents and a heavy economic burden.
作者
姬林娟
李星辉
孙小龙
毛华博
高锦霞
李宝恒
JI Lin-juan;LI Xing-hui;SUN Xiao-long;MAO Hua-bo;GAO Jin-xia;LI Bao-heng(College of Clinical Medicine,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China)
出处
《中国介入心脏病学杂志》
2020年第12期700-704,共5页
Chinese Journal of Interventional Cardiology
基金
甘肃省人民医院院内科研基金项目(18GSSY4-5)。
关键词
甘肃农村
冠心病
经皮冠状动脉介入治疗
抑郁
焦虑
Gansu rural area
Coronary heart disease
Percutaneous coronary intervention
Depression
Anxiety
