高血压合并抑郁和焦虑的临床分析  

Clinical analysis of hypertension complicated with depression and anxiety

作　　者：李晓 张海澄[1] 崔玉贤[1] 孙宁玲[1] 陈琦玲[1] 

机构地区：[1]北京大学人民医院心脏中心心血管内科,100044

出　　处：《中国医药》2016年第2期181-184,共4页China Medicine

摘　　要：目的探索高血压患者合并抑郁和焦虑的临床特点。方法回顾性分析2014年11月至2015年6月于北京大学人民医院高血压病房住院的449例高血压患者的临床资料。所有患者均进行抑郁自评量表（PHQ-9）和焦虑自评量表（GAD-7）评分，对其年龄、性别、病程、血压水平、合并症等临床特点进行统计学分析。结果449例高血压患者抑郁的发生率为37．9％（170／449），其中轻度抑郁107例、中度抑郁41例、中重度抑郁17例、重度抑郁5例；广泛性焦虑的发生率为35．2％（158／449），其中轻度广泛性焦虑115例、中度广泛性焦虑31例、重度广泛性焦虑12例。高血压患者中女性抑郁发生率明显高于男性[42．8％（101／236）比32．4％（69／213），P〈0．05]，老年抑郁和焦虑的发生率明显高于非老年[43．7％（104／238）比31．3％（66／211）、40．3％（96／238）比29．4％（62／211），P〈0．05]；抑郁患者的收缩压、舒张压水平明显高于无抑郁患者，差异有统计学意义[（149±22）mmHg（1mmHg=0．133kPa）比（143±19）mmHg、（87±17）mmHg比（84±15）mmHg，P〈0．05]，焦虑患者收缩压水平高于无焦虑患者，差异具有统计学意义[（148±22）mmHg比（144±20）mmHg，P〈0．05]；合并冠心病的高血压患者抑郁的发生率明显高于未合并冠心病者，差异有统计学意义[54．8％（63／115）比32．0％（107／334），P〈0．05]，合并周围动脉粥样硬化的高血压患者焦虑的发生率明显高于未合并周围动脉粥样硬化者，差异有统计学意义[38．8％（109／281）比29．2％（49／168），P〈0．05]，另外，合并周围动脉粥样硬化的高血压患者，轻度抑郁的发生率低于中重度抑郁，差异有统计学意义[61．7％（66／107）比76．2％（49／63），P〈0．05]。结论高血压患者抑郁和焦虑的发生率高，且以女性、老年、血压控制不良、多合并症人Objective To analyze the clinical characteristics of hypertension complicated with depression and anxiety. Methods Clinical data of 449 patients with hypertension from November 2014 to June 2015 were retrospectively analyzed. Self-rating depression scale （PHQ-9） and self-rating anxiety scale （GAD-7） were assessed; the age, gender, course of the disease, blood pressure levels and complications were statistically analyzed. Results The incidence of depression was 37.9% （ 170/449）, including 107 cases of mild depression, 41 cases of moderate depression, 17 cases of moderate-severe depression, and 5 cases of severe depression. The incidence of generalized anxiety was 35.2% （ 158/449 ） , including 115 cases of mild anxiety, 31 cases of moderate anxiety, 12 cases of severe anxiety. The incidence of depression was significantly higher in female patients than that in male patients I42.8% （101/236） vs 32.4% （69/213） ] （P 〈0.05） ; the incidences of depression and anxiety were significantly higher in elderly patients than those in non-elderly patients [43.7% （ 104/238 ） vs 31.3% （66/211）, 40.3% （96/238） vs 29.4% （62/211） ] （P 〈 0.05）. Besides, the systolic blood pressure and diastolic blood pressure in patients with depression were significantly higher than patients without depression I（149±22） mmHgvs （143 ±19） mmHg, （87±17） mmHgvs （84±15） mmHg] （P〈0.05）, the systolic blood pressure in patients with anxiety was significantly higher than patients without anxiety [ （ 148 ± 22 ） mmHg vs （144 ±20） mmHg] （P 〈0.05）. Moreover, the incidence of depression in patients with coronary heart disease was significantly higher than that in patients without coronary heart disease [54. 8% （63/115） vs 32.0% （107/334） ] （P 〈 0. 05 ）; the incidence of anxiety in patients with peripheral arteriosclerosis was significantly higher than that in patients without peripheral arteriosclerosis [ 38. 8% （ 109/281 ） vs 29. 2% （ 49/168 ） ] （

关 键 词：高血压 焦虑 抑郁 

分 类 号：R544.1[医药卫生—心血管疾病]