天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (4): 412-415.doi: 10.11958/j.issn.0253-9896.2015.04.021

• 专题研究·心血管疾病 • 上一篇    下一篇

冠心病再血管化治疗后发生抑郁的危险因素分析

解存1,2，丛洪良2,3△，李曦铭2，张茹艳2   

  1. 1天津医科大学（邮编300051）；2天津市胸科医院；3天津市心血管病研究所
  • 收稿日期:2014-09-04 修回日期:2014-12-14 出版日期:2015-04-15 发布日期:2015-04-13
  • 通讯作者: 丛洪良 E-mail:hongliangcong@126.com
  • 作者简介:解存（1987），女，硕士在读，主要从事冠心病研究
  • 基金资助:
    天津市科技计划重点项目（12ZCZDSY03200）,天津市卫生局科技重点攻关项目（12KG127）

Risk factors of depression in coronary heart disease patients who underwent revascularization therapy

XIE Cun1,2, CONG Hongliang2,3Δ, LI Ximing2, ZHANG Ruyan2   

  1. 1 Tianjin Medical University, Tianjin 300051, China; 2 Tianjin Chest Hospital; 3 Research Institute of Tianjin Cardiovascular Disease
  • Received:2014-09-04 Revised:2014-12-14 Published:2015-04-15 Online:2015-04-13
  • Contact: CONG Hongliang E-mail:hongliangcong@126.com

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摘要： 摘要：目的探讨冠心病患者再血管化治疗后抑郁的发生情况及其危险因素。方法选取拟在天津市胸科医院实施第一次再血管化治疗的冠心病患者493 例，其中行冠状动脉旁路移植术（CABG 组）258 例，行经皮冠状动脉介入术（PCI 组）235 例。根据术后抑郁自评量表（SDS）评分将2 组再分别分为抑郁组（＞52 分）和非抑郁组（≤52 分）。分别对比CABG 组和PCI 组抑郁与非抑郁患者的基本临床资料，并进行术后发生抑郁的多因素Logistic 回归分析。结果CABG 组术后抑郁的发生率34.88%（90/258）高于PCI 组22.98%（54/235）。（1）CABG 组。抑郁组年龄、女性、饮酒史、既往抑郁史、术前抑郁、麻醉时间、ICU 停留时间和术后认知功能障碍（POCD）发生率均高于非抑郁组；女性和术前抑郁是CABG 患者术后发生抑郁的独立危险因素。（2）PCI 组。抑郁组女性、高血压病史、糖尿病病史、既往心肌梗死病史、介入治疗时间和支架植入数目均高于非抑郁组(均Ρ＜0.05)；女性、既往心肌梗死病史和介入治疗时间长是PCI 患者术后发生抑郁的独立危险因素。结论冠心病患者行CABG 或PCI 术后均有较高比例的抑郁发生，女性是冠心病患者再血管化治疗后发生抑郁的独立危险因素。

关键词: 冠心病, 冠状动脉分流术, 血管成形术, 经腔, 经皮冠状动脉, 抑郁, 女(雌)性, 再血管化治疗

Abstract: Abstract: Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting (CABG) and the rest 235 patients underwent percutaneous coronary intervention (PCI). Self-rating depression scale (SDS) was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera⁃ tive scores, CABG group was divided into the depression group (n=90) and non-depression group (n=168) while PCI group was also divided into depression group (n=54) and non-depression group (n=181). Basic clinical datum of patients were col⁃ lected and analyzed and independent risk factors of depression was analyzed though logistic multi- variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients (P＜0.05).（1）In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction（POCD）were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper⁃ ative depression in patients underwent CABG.（2）In PCI group, ratio of female gender, blood pressure, incidence of Diabe⁃ tes Mellitus, the rate of past Myocardiac infaction (MI), length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa⁃ tients underwent revascularization is high. Female is the dependent risk factor in both CABG group and PCI group. Com⁃ pared with PCI, CABG had greater influence on development of depression in postoperative patients.

Key words: coronary disease, coronary artery bypass, angioplasty, transluminal, percutaneous coronary, depression, fe? male, revascularization