抑郁冠心病患者高敏C反应蛋白及P选择素水平与预后  

The correlation between the hs-CRP and P-selectin level and prognosis in CHD patients with depression

作　　者：周建芝[1] 穆树敏[2] 薄海美[2] 张志强[2] 张放[2] 王晓春[2] 黄宇玲[2] 李素新[2] 赵丽娜[2] 王志军[2] 

机构地区：[1]河北联合大学校医院,河北唐山063000 [2]河北联合大学附属医院心内科

出　　处：《临床心血管病杂志》2013年第10期769-771,共3页Journal of Clinical Cardiology

基　　金：唐山市科学技术研究与发展计划项目(No:08130207a)

摘　　要：目的:分析冠心病(CHD)患者的抑郁状态与CHD的临床类型(心绞痛、心肌梗死)、高敏C反应蛋白(hs-CRP)及P选择素的关系,观察抑郁与随访1年主要心血管不良事件(MACE)的关系。方法:将入选的336例患者分为对照组、心绞痛组和心肌梗死组,应用焦虑自评量表分析系统评估患者的抑郁状态。检测血浆hsCRP与P选择素水平。随访1年,观察抑郁患者MACE的发生情况。结果:336例患者抑郁109例(32.4%),其中对照组9例(16.4%),心绞痛组43例(28.1%),心肌梗死组57例(44.5%),各组差异有统计学意义(均P<0.05)。对照组抑郁与非抑郁患者hs-CRP水平分别为(3.06±1.78)mg/L与(1.82±1.33)mg/L,心绞痛组为(8.74±7.23)mg/L与(4.61±4.26)mg/L,心肌梗死组为(12.21±7.23)mg/L与(9.30±6.82)mg/L,均差异有统计学意义(均P<0.05)。对照组抑郁与非抑郁患者P选择素水平分别为(18.04±2.02)ng/L与(16.02±3.15)ng/L,心绞痛组为(30.24±5.83)ng/L与(25.56±6.08)ng/L,心肌梗死组为(33.53±4.91)ng/L与(29.32±5.43)ng/L,均差异有统计学意义(均P<0.05)。随访1年,抑郁患者MACE发生率高于非抑郁患者(31.2%∶17.2%,P<0.05)。结论:抑郁与CHD及其严重程度有关,是MACE发生的危险因素。抑郁患者hs-CRP与P选择素水平显著高于非抑郁患者。Objective：To analyze the relationship between depression and coronary heart disease （CHD）, the levels of high sensitivity C reactive protein （hs-CRP） and P-selectin. To observe the major adverse cardiac events （MACE） in 1 year follow-up. Method：All 336 patients were selected and divided into control group, angina pecto- ris group, myocardial infarction group. The anxiety self-assessment scale analysis system was applied for evalua- ting the patients＇ depressive state. Hs-CRP and P-selectin levels were detected. Patients were followed up for 1 year to observe the incidence of MACE. Result： One hundred and nine patients （32.4%） were depression. Depres- sion cases in control group, angina and myocardial infarction patients were 9 （16.4%）, 43 （28.1%） and 57 （44.5 %） respectively （all P〈0. 05）. Hs-CRP levels of depressed and non-depressed patients in control group, angina pectoris group and myocardial infarction group were （3.06 ± 1.78）mg/L and （1.82 ± 1.33）rag/L, （8.74 ± 7.23） mg/L and （4.61±4.26 ） mg/L, （ 12.21 ± 7.23 ） and （ 9.30 ± 6.82 ） mg/L respectively （ all P 〈 0.05 ）. P- selectin levels of depressed and non-depressed patients in control group, angina pectoris group, myocardial infarc- tion group were （18.04±2.02）ng/L and （16.02±3.15）ng/L, （30.24±5.83）ng/L and （25.56±6.08）ng/L, （33.53±4.91）ng/L and （29.32±5.43）ng/L, respectively （all P〈0.05）. Patients were foil.owed up for 1 year, and 34 cases （31.2%） with depression occurred MACE, much higher than that without depression （39 cases, 17.2 % ） （P〈0.05）. Conclusion：Depression is a risk factor of CHD and relates with the severity of CHD. Hs-CRP and P-selectin levels of depressed patients are significantly higher than those without depression. The incidence of 1-year follow-up MACE in patients with depression is obviously higher than that without depression.

关 键 词：冠心病 抑郁 高敏C反应蛋白 P选择素 

分 类 号：R541.4[医药卫生—心血管疾病]