冠状动脉旁路移植术患者围术期抑郁筛查及生活质量水平评估  

The Evaluation of Depression and Quality of Life in Patients Undergoing Coronary Artery Bypass Graft at Perioperative Stage

作　　者：岳超[1] 杨立猛[1] 赵燕[1] 赵明昊[1] 芮路[1] 侯斌[1] 谢衍博 赵振华[1] 张本青[1] 郑哲[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院心血管病再生医学重点实验室,北京市100037

出　　处：《中国分子心脏病学杂志》2015年第3期1316-1317,共2页Molecular Cardiology of China

基　　金：十二五国家科技支撑计划(2011BAI11B02 2011BAI11B21)

摘　　要：目的明确冠状动脉旁路移植术患者围术期抑郁的发生情况与生活质量水平变化。方法本研究是一项前瞻性的观察性临床研究,入选自2012年7月至2013年11间在阜外心血管病医院首次接受CABG患者。入选标准:1)年龄小于18周岁;2)既往接受冠状动脉旁路移植术;3)因语言障碍而无法完成问卷。分别应用汉密尔顿-17项抑郁量表(HAMD-17)与生活质量评估量表SF-36评估患者术前及术后1个月的抑郁发生情况与患者生活质量水平。结果共入选446人,患者平均年龄为(60.03±8.37)岁,女性患者89例(20.0%)。本研究人群术前抑郁的发生率31.3%,术后1个月为27.5%;全部患者术前与术后HAMD-17抑郁评分平均值分别为6.0±4.9、3.6±4.0,两者有统计学差异。全部患者术前SF-36量表中身体基能评分术前与术后分别为58.1±21.1、56.5±25.4,心理机能评分术前与术后分别为69.4±20.9、74.7±22.8。结论冠状动脉旁路移植术患者围术期抑郁发生率较高,术后1个月抑郁发生率与症状较术前有显著的降低,生活质量也有部分改善。这说明冠脉旁路移植术作为冠心病的主要治疗手段,可以显著改善冠心病患者抑郁的发生并提高患者早期的生活质量。Objective This study is designed to determine the prevalence of depression and evaluate the quality of life in perioperative patients with coronary artery bypass grafting. Methods This study was designed as one prospective and observational clinical study. Consecutive patients undergoing first-time selective coronary bypass surgery in Fuwai Hospital from the time of July 2012 to November 2013 were included in this study. The exclusion criteria include： （1） less than 18 years of age （2） previous CABG surgery （3） communicational difficulties. Each participant was evaluated depressive symptoms and the quality of life before operation and 1 month after bypass surgery by Hamilton depression Scale-17 （HAMD-17） and the MOS 36- item Short Form Health Survey （SF-36）. Results The study population consists of 446 participants with a mean age of 60.0±8.4 years and 80 cases （20.0%） were female. 31.3% met the criteria of diagnosis of depressive disorders before surgery, 27.5% met the criteria after surgery for 1 month. The mean value of HAMD-17 scores at preoperation and 1 month after surgery were 6.0±4.9 vs 3.6±4.0 （P〈0.001）. Preoperative and postoperative Physical Component Summary score （PCS） were 58.1±21.1 vs 56.5±25.4 and Mental Component Summary score （MCS） were 69.4±20.9 vs 74.7±22.8 included in SF-36 score system. Conclusions The incidence of depression in bypass patients is high. Compared with the preoperative depression in bypass patients, the depressive symptoms decreased significantly and the improvement in quality of life was found in CABG patients 1 month after surgery. This also showed the coronary artery bypass grafting as the primary treatment for coronary artery disease （CAD） can help to improve the symptoms of depression in CAD patients and promote the quality of life.

关 键 词：抑郁 生活质量 冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]