伴抑郁情绪内科门诊患者的血管内皮功能  

Endothelial function in medical outpatients with depressive symptom

作　　者：石慧[1] 钟光珍[1] 王喆[1] 冯国双[2] 胡永东[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020 [2]中国疾病预防控制中心,北京102206

出　　处：《中国心理卫生杂志》2014年第7期481-485,共5页Chinese Mental Health Journal

基　　金：北京市科技新星计划(2008B62);北京卫生系统高层卫生技术人才项目(2011);国家自然科学基金(81300148)

摘　　要：目的:探讨内科门诊患者的抑郁情绪与血管内皮功能的关系。方法:采用横断面调查,选取就诊于三甲综合医院内科门诊,汉密顿抑郁量表17项评分≥17分和临床总体印象评分≥4分的63例患者作为伴抑郁情绪组,选取汉密顿抑郁量表17项评分<7分、汉密顿焦虑量表评分≤6分、临床总体印象评分≤2分的63例患者作为无抑郁情绪组,两组年龄与体质量指数均匹配。调查患者是否存在冠心病、糖尿病、脑梗死病史,并对血糖、血脂、血压指标进行测查,采用Endo-PAT2000检测仪评估内皮功能指数(RHI)。结果:多重线性回归分析结果显示,RHI水平与伴抑郁情绪呈负向关联(β'=-0.31,P<0.001)。按有/无冠心病病史分层分析伴抑郁情绪与RHI水平的关系,有冠心病病史的患者中,伴抑郁情绪者(n=28)与无抑郁情绪组(n=22)的RHI差异无统计学意义[(1.8±0.5)vs.(1.8±0.7),P>0.05];无冠心病病史的患者中,伴抑郁情绪者(n=47)的RHI水平低于无抑郁情绪者(n=53)[(2.1±0.6)vs.(2.4±0.6),P<0.05]。结论:内科门诊抑郁情绪患者可能存在内皮功能障碍。Objective：To study the relationship of depressive symptom and endothelial function in medical outpatients.Methods：In this cross-sectional study,63 medical outpatients in a third-grade class-A general hospital patients were selected as group with depressive symptom （with the Hamilton Depression Scale-17 items （HAMD17） scores of ≥ 17 and Clinical Global Impression of Illness （CGI） scores of ≥4）.Sixty-three patients with HAMD17 scores of ＜7 and Hamilton Anxiety Scale （HAMA） scores of ≤6 and CGI scores of ≤2 were selected as group without depressive symptom.The two groups of patients were age-and body mass indexmatched.All subjects＇ history of coronary heart disease （CHD）,diabetes and cerebral infarction were investigated and the blood glucose,blood lipid and blood pressure were examined.The endothelial function （reactive hyperemia index,RHI） were tested with the EndoPAT-2000.Results：Multiple linear regression analysis showed that the RHI were negatively associated with depressive symptom （β =-0.313,P ＜ 0.001）.The stratified analysis by the history of CHD showed the relationship between group and RHI.In patients with CHD,there was no difference in RHI between those with depressive symptom （n =28） and those without depressive symptom （n =22） [（1.8 ± 0.5） vs.（1.8 ± 0.7）,P ＞ 0.05].In patients without CHD,the RHI were lower in those with depressive symptom （n =47）than those without depressive symptom （n =53） [（2.1 ±0.6） vs.（2.4 ±0.6）,P ＜0.05].Conclusion：It suggests that medical outpatients with depressive symptom maybe have endothelial dysfunction.

关 键 词：抑郁 血管内皮功能 冠心病 横断面研究 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R541.4[医药卫生—临床医学]