充血性心力衰竭住院患者抑郁状态分析及心理干预效果评价  

Analysis of depression state and the evaluation of mental intervention effect among patients with congestive heart failure

作　　者：李中清[1] 潘发明[2] 

机构地区：[1]安徽医科大学第一附属医院心内科,安徽合肥230061 [2]安徽医科大学公共卫生学院流行病与卫生统计学系,安徽合肥230032

出　　处：《中华疾病控制杂志》2012年第6期502-505,共4页Chinese Journal of Disease Control & Prevention

摘　　要：目的了解充血性心力衰竭(congestive heart failure,CHF)住院患者的抑郁状态,探讨对其实施心理干预的效果。方法采用Zung抑郁自评量表(self-rating depression scale,SDS)对257例CHF住院患者入院当日或次日进行问卷调查,共筛查出133例患者存在不同程度的抑郁状态,按性别、年龄、病程、基础心脏病和心功能分级相近进行成组匹配,将133例患者分为试验组和对照组,对照组(66例)在治疗的同时行心衰常规护理,试验组(67例)在此基础上每天进行针对性心理干预,7～10 d后再次进行SDS问卷调查。结果 CHF住院患者抑郁发生率为51.8%,不同病程和心功能分级组之间SDS评分差异有统计学意义(均有P<0.001);干预后SDS得分试验组低于对照组(t=7.22,P<0.001),干预前两组抑郁程度等级经比较差异无统计学意义(Z=1.05,P=0.296),干预后试验组抑郁程度低于对照组(Z=6.08,P<0.001)。结论 CHF患者抑郁状态发生率较高,且心衰病程及心功能级别可能与抑郁的发生有关;针对式的心理干预可以有效减轻或消除CHF患者的抑郁症状,有利于CHF的治疗与早日康复。Objective To investigate the depression state of patients with congestive heart failure（CHF） and discuss the effect of mental intervention. Methods 257 new patients with CHF in hospital were involved in Zung＇ s self-rating depression scale（SDS） questionnaire survey. The survey was undertaken on the first day or the second day during patients＇ hospitalization. 133 of the 257 patients （51.8%） showed different degrees of depression state. Then the 133 patients were divided into 2 groups by sex, age, duration of underlying diseases and NYHA classification. The experimental group （67 cases） were treated with psychological intervention care and control group （66 cases） were treated with the routine care. After 7-10 d, questionnaire survey was undertaken again. Results SDS scores were different（P〈0. 001 ） between patients of the different disease durations and NYHA classifications. SDS scores were lower in the experimental group than in the control group after the intervention （t=7.22, P〈0. 001 ）. There was no significant difference in degrees of depression between two groups before intervention （ Z= 1.05, P = 0. 296 ）. The degree of improvement of clinical symptoms was higher in experiment group than in control group after the intervention （Z= 6.08, P〈0. 001 ）. Conclusions Depression were particularly common symptoms in patients with heart failure. Pathogenesis and cardiac function were correlated to depression. Psychological intervention can relieve the depression symptoms and promote recovery of patients with CHF.

关 键 词：心力衰竭 抑郁 干预性研究 

分 类 号：R541.61[医药卫生—心血管疾病] R749.42[医药卫生—内科学]