抑郁对冠心病患者生存质量和运动耐力的影响  

Effects of Depression on Quality of Life and Exercise Tolerance in Patients with Coronary Heart Disease

作　　者：倪奕[1] 王乐民[1] 沈玉芹[1] 车琳[1] 张启萍[1] 李广鹤[1] 

机构地区：[1]上海市同济医院心内科,200065

出　　处：《心脑血管病防治》2014年第1期5-7,10,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12010117);上海市重大科技攻关基金资助项目(05DZ19505)

摘　　要：目的探讨抑郁对冠心病(CHD)患者生存质量、运动耐力的影响程度。方法 131例CHD患者由本人独立填写完成贝克抑郁自评量表(BDI)和简明健康测量量表(SF-36)。根据BDI评分将患者分为抑郁组(n=34)、非抑郁组(n=97)并分别行心肺运动试验(CPET)。结果 (1)131例CHD患者SF-36各维度均低于中国常模,除社会功能外各维度有显著差异(P<0.01),抑郁组CHD患者SF-36各维度得分均低于非抑郁组患者,除生理功能、生理职能外各维度有显著差异(P<0.05,或P<0.01)。(2)抑郁组CHD患者CPET结果中峰值氧耗量(VO2peak)、无氧代谢阈值氧耗量(VO2AT)、无氧代谢阈值负荷(LoadAT)均低于非抑郁组,分别为VO2peak:(17.3±1.7)ml·kg-1·min-1比(18.6±2.9)ml·kg-1·min-1,P<0.05;VO2AT:(12.0±1.7)ml·kg-1·min-1比(13.2±2.2)ml·kg-1·min-1,P<0.01;LoadAT:(30.7±11.4)J·s-1比(36.0±13.9)J·s-1,P<0.05。(3)CHD患者SF-36与运动耐力有相关性(P<0.05);SF-36各维度得分与BDI评分有显著负相关性(P<0.05);BDI评分与CPET结果中VO2peak、VO2AT、LoadAT有显著负相关性(P<0.05)。结论合并抑郁的冠心病患者生存质量和运动耐力下降,抑郁与冠心病患者生存质量和运动耐力密切相关。Objective To explore effects of depression on quality of life and exercise tolerance in patients with coronary heart disease （CHD）. Methods 131 patients with CHD completed Beck Depression Inventory （BDI） and the MOS 36_Item Short_From Health sur-vey（SF-36）independently.According to the scores of BDI ,the patients were divided into depression group （n=34） and non_depres-sion group （n=97）.Both groups were given cardiopulmonary exercise testing （CPET）.Results （1） Compared with Chinese norms , the scores on all subscales of SF-36 in 131 patients with CHD were lower ,and there were significant differences on all subscales of SF-36 except that related to social function （ P〈0.01）.Furthermore ,the scores on all subscales of SF-36 in depression group were lower than non_depression group ,there were significant differences on all subscales of SF-36 except those related to physical function and physical role （P〈0.05 ,or P〈0.01）. （2） The peak oxygen consumption （VO2peak：） ,threshold of oxygen consumption of anaerobic metabolism （VO2 AT ） ,threshold anaerobic metabolism load （LoadAT ） in depression group were lower than those in non_de-pression.VO2peak：（17.3 ± 1.7）ml·kg^-1·min^-1 vs. （18.6 ± 2.9）ml·kg^-1·min^-1 , P〈0.05;VO2AT：（12.0 ± 1.7）ml·kg^-1· min^-1 vs.（13.2 ± 2.2）ml·kg^-1·min^-1 ,P〈0.01;LoadAT ：（30.7 ± 11.4）J·s^-1 vs.（36.0 ± 13.9）J·s^-1 ,P〈0.05.（3） In patients with CHD ,the scores of SF-36 and exercise tolerance were significantly correlated （ P〈0.05）;the scores on all subscales of SF-36 measured by BDI were significantly negatively correlated （P〈0.05）;the scores measured by BDI and VO2peak ,VO2AT ,LoadAT during CPET were significantly negatively correlated （ P〈0.05 ）. Conclusions Quality of life and exercise tolerance of patients with CHD complicating depression decreased severely ,and quality of life and exercise tolerance closely related to depression.

关 键 词：冠状动脉疾病 抑郁 生存质量 运动耐力 心肺运动试验 

分 类 号：R541.4[医药卫生—心血管疾病]