老年冠心病患者与抑郁障碍的相关性研究  

Association of depressive disorder with coronary artery disease in elderly patients

作　　者：陈莹[1] 常志文[1] 翟艳苓[2] 

机构地区：[1]首都医科大学附属北京同仁医院干部医疗科,100730 [2]首都医科大学附属北京同仁医院血液科,100730

出　　处：《中华老年医学杂志》2011年第7期551-554,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨抑郁障碍是否为老年冠心病的危险因素并观察冠心病伴抑郁障碍患者炎性标记物水平变化。方法对188例入选者进行临床情况调查、汉密顿抑郁量表评分和血清炎性标记物水平测定，分析冠心病伴抑郁障碍患病率及影响冠心病发病的危险因素。结果冠心病患者87例，其抑郁障碍患病率为29．9％（26例），非冠心病人选者lOl例，患病率为11．9％（12例），抑郁障碍在两组间差异有统计学意义（P〈0．01）。年龄、高血压、糖尿病、脂代谢异常和抑郁障碍是冠心病的危险因素之一。冠心病伴抑郁障碍组和冠心病不伴抑郁障碍组人选者在突发生活事件、心功能分级差异有统计学意义（均P〈0．05）。两组入选者在冠状动脉病变、冠状动脉病变治疗差异无统计学意义（P〉O．05）。冠心病伴抑郁障碍组和冠心病不伴抑郁组外周血炎性标记物水平比较显示，伴抑郁障碍组血清单核细胞趋化因子-1水平增高，高敏C反应蛋白和肿瘤坏死因子α差异无统计学意义。结论老年冠心病患者伴抑郁障碍患病率高于老年非冠心患者群。抑郁障碍是影响冠心病发病的危险因素之一。老年冠心病患者抑郁障碍与炎性标记物之间可能存在一定关系。Objective To explore whether depressive disorder is one of risk factors for coronary artery disease （CAD） in enrolled patients and observe the level of inflammation markers in coronary artery disease patients with depression. Methods In all patients, we recoded clinical information and data from Hamilton Depression Rating Scale for Depression（HRSD）and measured concentration of monocyte chemoattractant protein-1 （MCP-1）, tumour necrosis factor α（TNFα） and hypersensitive C-reaction protein （hsCRP）. Results Among 87 patients with coronary artery disease, depressive disorder was diagnosed in 26 patients, the prevalence of depressive disorder was 29.9%. Among 101 patients without coronary artery disease, 12 patients were suffering from depressive disorder, the prevalence of depressive disorder was 11.9 %. The prevalence of depressive disorder in coronary artery disease group was statistically higher than that in non-coronary heart disease group （29.8% vs. 11.9%, P（0.01）. The incidence of coronary artery disease was associated with age, hypertension, diabetes mellitus, hypercholesterolemia and depression. Life events and stage of heart function occurred differently between CAD patients with and without depression （P〈0.05）. There were no differences in the degree of coronary artery stenosis and the type of treatment （P〉0.05） between the two groups. There were higher concentration of MCP-1 in coronary artery disease patients with depression, but no remarkable difference in hsCRP and TNFα. Conclusions There is high prevalence of depressive disorder, which is one of risk factor for coronary artery disease. The depressive disorder may be associated with inflammation biomarker in patients with coronary artery disease.

关 键 词：冠状动脉疾病 抑郁症 炎症 

分 类 号：R541.4[医药卫生—心血管疾病]