冠心病再血管化治疗后发生抑郁的危险因素分析  

Risk factors of depression in coronary heart disease patients who underwent revascularization therapy

作　　者：解存 丛洪良[2,3] 李曦铭[2] 张茹艳[2] 

机构地区：[1]天津医科大学,300051 [2]天津市胸科医院 [3]天津市心血管病研究所

出　　处：《天津医药》2015年第4期412-415,共4页Tianjin Medical Journal

基　　金：天津市科技计划重点项目(12ZCZDSY03200);天津市卫生局科技重点攻关项目(12KG127)

摘　　要：目的探讨冠心病患者再血管化治疗后抑郁的发生情况及其危险因素。方法选取拟在天津市胸科医院实施第一次再血管化治疗的冠心病患者493例,其中行冠状动脉旁路移植术(CABG组)258例,行经皮冠状动脉介入术(PCI组)235例。根据术后抑郁自评量表(SDS)评分将2组再分别分为抑郁组(>52分)和非抑郁组(≤52分)。分别对比CABG组和PCI组抑郁与非抑郁患者的基本临床资料,并进行术后发生抑郁的多因素Logistic回归分析。结果 CABG组术后抑郁的发生率34.88%(90/258)高于PCI组22.98%(54/235)。(1)CABG组。抑郁组年龄、女性、饮酒史、既往抑郁史、术前抑郁、麻醉时间、ICU停留时间和术后认知功能障碍(POCD)发生率均高于非抑郁组;女性和术前抑郁是CABG患者术后发生抑郁的独立危险因素。(2)PCI组。抑郁组女性、高血压病史、糖尿病病史、既往心肌梗死病史、介入治疗时间和支架植入数目均高于非抑郁组(均Ρ<0.05);女性、既往心肌梗死病史和介入治疗时间长是PCI患者术后发生抑郁的独立危险因素。结论冠心病患者行CABG或PCI术后均有较高比例的抑郁发生,女性是冠心病患者再血管化治疗后发生抑郁的独立危险因素。Objective To explore the incidence and risk factors of depression in coronary heart disease patients who underwent revascularization therapy. Methods A total of 493 patients who were admitted in Tianjin chest hospital from April 2012 to February 2013 were enrolled, among whom 258 patients acceptted coronary artery bypass grafting （CABG） and the rest 235 patients underwent percutaneous coronary intervention （PCI）. Self-rating depression scale （SDS） was employed to assess the state of patients at both1 day before and 7 days after the operations. According to the postopera？tive scores, CABG group was divided into the depression group （n=90） and non-depression group （n=168） while PCI group was also divided into depression group （n=54） and non-depression group （n=181）. Basic clinical datum of patients were col？lected and analyzed and independent risk factors of depression was analyzed though logistic multi-variant regression. Results The incidence of postoperative depression among CABG patients was significantly higher than that in PCI patients （P〈0.05）.（1）In the CABG group, age, ratio of female gender, alcohol intake, rate of past depression, length of anaesthesia, length of staying in ICU and incidence of postoperative cognitive dysfunction（POCD）were all higher in depression subgroup than those in non-depression subgroup. Female and preoperative depression were both independent risk factors for postoper？ative depression in patients underwent CABG.（2）In PCI group, ratio of female gender, blood pressure, incidence of Diabe？tes Mellitus, the rate of past Myocardiac infaction （MI）, length of intervention therapy and the number of planted stents were all higher in depression subgroup than non-depression subgroup. Female, past MI and length of intervention therapy are all independent factors of post-operative depression in patients underwent PCI. Conclusion Incidence of depression in pa？tients underwent revascularization is high. Female is the dependent risk fact

关 键 词：冠心病 冠状动脉分流术 血管成形术 经腔 经皮冠状动脉 抑郁 女(雌)性 再血管化治疗 

分 类 号：R541.4[医药卫生—心血管疾病]